Healthcare Provider Details

I. General information

NPI: 1144607672
Provider Name (Legal Business Name): ECB MEDICAL DR THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 05/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5190 NW 167TH ST STE 102
MIAMI LAKES FL
33014-6328
US

IV. Provider business mailing address

5190 NW 167TH ST STE 102
MIAMI LAKES FL
33014-6328
US

V. Phone/Fax

Practice location:
  • Phone: 786-458-2941
  • Fax: 305-458-6379
Mailing address:
  • Phone: 786-458-2941
  • Fax: 305-458-6379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANKLIN D SAUMEL
Title or Position: P
Credential: MD
Phone: 786-458-2941