Healthcare Provider Details

I. General information

NPI: 1972540391
Provider Name (Legal Business Name): EXCLUSIVE HEALTH SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 SW 24TH ST
MIAMI FL
33155-6538
US

IV. Provider business mailing address

6703 SW 25TH ST
MIAMI FL
33155-2901
US

V. Phone/Fax

Practice location:
  • Phone: 305-269-6788
  • Fax: 305-269-6708
Mailing address:
  • Phone: 305-505-8818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARLENE LOPEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-269-6788