Healthcare Provider Details

I. General information

NPI: 1215632419
Provider Name (Legal Business Name): MIAMI FERTILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 BALTIMORE WAY, PH3A
CORAL GABLES FL
33134
US

IV. Provider business mailing address

550 BALTIMORE WAY, PH3A
CORAL GABLES FL
33134
US

V. Phone/Fax

Practice location:
  • Phone: 305-800-2229
  • Fax:
Mailing address:
  • Phone: 305-800-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JAYME BUNCH
Title or Position: DIRECTOR OF INTEGRATION
Credential:
Phone: 480-560-7729