Healthcare Provider Details

I. General information

NPI: 1174961833
Provider Name (Legal Business Name): DOCTORS ALLIANCE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 41ST ST 103
MIAMI BEACH FL
33140-3516
US

IV. Provider business mailing address

400 W 41ST ST 201
MIAMI BEACH FL
33140-3516
US

V. Phone/Fax

Practice location:
  • Phone: 305-695-0644
  • Fax: 305-532-1612
Mailing address:
  • Phone: 305-695-0644
  • Fax: 305-532-1612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. MIGUEL ISAAC GARCIA
Title or Position: CEO & PRESIDENT
Credential: M.D., MBA
Phone: 305-695-0644