Healthcare Provider Details

I. General information

NPI: 1306925169
Provider Name (Legal Business Name): TRIANGLE MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1726 NW 36TH ST STE 19-20
MIAMI FL
33142-5433
US

IV. Provider business mailing address

1726 NW 36TH ST STE 19-20
MIAMI FL
33142-5433
US

V. Phone/Fax

Practice location:
  • Phone: 305-635-2010
  • Fax:
Mailing address:
  • Phone: 305-635-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number
License Number State

VIII. Authorized Official

Name: MARIELA PENTON
Title or Position: PRESIDENT
Credential:
Phone: 305-281-5649