Healthcare Provider Details

I. General information

NPI: 1376800441
Provider Name (Legal Business Name): PASTEUR MEDICAL MIAMI GARDENS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 NW 183RD ST
HIALEAH FL
33015-6025
US

IV. Provider business mailing address

9250 W FLAGLER ST STE 600
MIAMI FL
33174-3460
US

V. Phone/Fax

Practice location:
  • Phone: 305-722-8561
  • Fax:
Mailing address:
  • Phone: 786-422-6821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TARIK HAWATMEH
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 786-422-6821