Healthcare Provider Details
I. General information
NPI: 1710982236
Provider Name (Legal Business Name): HEALTH SERVICES OF MIAMI
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/21/2005
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2319 W 76TH ST
HIALEAH FL
33016-1842
US
IV. Provider business mailing address
2319 W 76TH ST
HIALEAH FL
33016-1842
US
V. Phone/Fax
- Phone: 305-557-3159
- Fax: 305-558-0701
- Phone: 305-557-3159
- Fax: 305-558-0701
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 5047B2 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | PH13111 |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
GILBERTO
PINTO
Title or Position: PRESIDENT
Credential:
Phone: 305-557-3159