MEDICARE: ALIANZA MEDICAL OFFICE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170100000X	Ph.D. Medical Genetics

General Provider Information

NPI Number	:	1447310412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALIANZA MEDICAL OFFICE INC

Provider Business Mailing Address
First Line	:	11200 W FLAGLER ST
Second Line	:	SUITE#212
City	:	MIAMI
State	:	FL
Zip	:	33174-4210
Country	:	US
Telephone Number	:	786-253-8115
Fax Number	:

Provider Business Practice Location Address
First Line	:	11200 W FLAGLER ST
Second Line	:	SUITE#212
City	:	MIAMI
State	:	FL
Zip	:	33174-4210
Country	:	US
Telephone Number	:	786-253-8115
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALINA MUNOZ
Credential	:
Telephone Number	:	786-253-8115

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	12/12/2007

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