Healthcare Provider Details

I. General information

NPI: 1003000290
Provider Name (Legal Business Name): XCELLENT MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 W FLAGLER ST
CORAL GABLES FL
33134-1608
US

IV. Provider business mailing address

3900 W FLAGLER ST
CORAL GABLES FL
33134-1608
US

V. Phone/Fax

Practice location:
  • Phone: 305-476-0069
  • Fax: 305-476-0070
Mailing address:
  • Phone: 305-476-0069
  • Fax: 305-476-0070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberHCC4227
License Number StateFL

VIII. Authorized Official

Name: ISR AEL RODRIGUEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-476-0069