is a Clinic/center in Miami, Florida. practices all healthcare services and medical treatments related to Clinic/center. The NPI Number for is 1285843664. The last update date is .
's current location address is 434 S.w. 12 Avenue, Miami, Florida. You can contact this provider via phone number 3056442125 and fax number 3056442126. The mailing address for is 434 S.w. 12 Avenue, Miami, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 434 S.w. 12 Avenue, Miami, Florida |
| Phone Number | 3056442125 |
| Fax Number | 3056442126 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1285843664 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 434 S.w. 12 Avenue |
|---|---|
| City | Miami |
| State | Florida (FL) |
| Post Code | 33135 |
| Phone Number | 3056442125 |
| Fax Number | 3056442126 |
Provider's Primary Taxonomy Detail
| Speciality | Clinic/center |
|---|---|
| Taxonomy | 261Q00000X |
| Licence No | HCC4492 |
|
Definition: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| HCC4492 | FL | AHCA LICENSE |
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