Healthcare Provider Details

I. General information

NPI: 1851341002
Provider Name (Legal Business Name): ESTRELLA MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4795 W FLAGLER ST
CORAL GABLES FL
33134-1470
US

IV. Provider business mailing address

4795 W FLAGLER ST
CORAL GABLES FL
33134-1470
US

V. Phone/Fax

Practice location:
  • Phone: 305-854-5631
  • Fax: 305-826-6929
Mailing address:
  • Phone: 305-982-8810
  • Fax: 305-826-6929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. YIPSI MARTIN
Title or Position: PRESIDENT
Credential:
Phone: 305-982-8810