Healthcare Provider Details

I. General information

NPI: 1912358169
Provider Name (Legal Business Name): SIGNAL MEDICAL MANAGEMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1688 MERIDIAN AVE
MIAMI BEACH FL
33139-2710
US

IV. Provider business mailing address

1000 VENETIAN WAY APT 1303
MIAMI BEACH FL
33139-1011
US

V. Phone/Fax

Practice location:
  • Phone: 954-816-3007
  • Fax: 954-337-0146
Mailing address:
  • Phone: 954-816-3007
  • Fax: 954-337-0146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JORGE LUIS BASTO
Title or Position: PRESIDENT
Credential:
Phone: 954-816-3007