Healthcare Provider Details

I. General information

NPI: 1679655880
Provider Name (Legal Business Name): B & C FAMILY HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7761 NW 146TH ST
HIALEAH FL
33016-1559
US

IV. Provider business mailing address

7761 NW 146TH ST
HIALEAH FL
33016-1559
US

V. Phone/Fax

Practice location:
  • Phone: 305-822-5896
  • Fax: 305-822-4260
Mailing address:
  • Phone: 305-822-5896
  • Fax: 305-822-4260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERTO CUCURULLO
Title or Position: VICE PRESIDENT
Credential: PA
Phone: 305-822-5896