Healthcare Provider Details

I. General information

NPI: 1528425857
Provider Name (Legal Business Name): SUPERIOR HEALTHCARE & RESEARCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2016
Last Update Date: 08/01/2020
Certification Date: 08/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7930 NW 36TH ST STE 214-215
DORAL FL
33166-6666
US

IV. Provider business mailing address

7930 NW 36TH ST STE 214-215
DORAL FL
33166-6666
US

V. Phone/Fax

Practice location:
  • Phone: 305-763-2384
  • Fax:
Mailing address:
  • Phone: 305-763-2384
  • Fax: 877-347-5666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MR. NOSLEN SANCHEZ MESA
Title or Position: PRESIDENT
Credential:
Phone: 305-763-2384