Healthcare Provider Details

I. General information

NPI: 1104742014
Provider Name (Legal Business Name): MIC INFUSION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 SW 288TH ST STE 210
HOMESTEAD FL
33033-1249
US

IV. Provider business mailing address

543 NW 3RD ST
FLORIDA CITY FL
33034-3205
US

V. Phone/Fax

Practice location:
  • Phone: 305-209-4994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. GABRIELA LORELEITH NARVAEZ-ACOSTA
Title or Position: PRESIDENT
Credential:
Phone: 305-797-4042