Healthcare Provider Details
I. General information
NPI: 1386654630
Provider Name (Legal Business Name): BERAJA HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2006
Last Update Date: 08/06/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2550 S DOUGLAS RD STE 100
CORAL GABLES FL
33134-6182
US
IV. Provider business mailing address
2550 S. DOUGLAS ROAD SUITE 100
CORAL GABLES FL
33134-6182
US
V. Phone/Fax
- Phone: 239-985-7171
- Fax: 392-985-7118
- Phone: 305-443-7070
- Fax: 305-770-6079
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name:
ALBERTO
J
ARAN
Title or Position: MEDICAL DIRECTOR AND DIRECTOR
Credential: M.D.
Phone: 305-205-2325