Healthcare Provider Details

I. General information

NPI: 1285021212
Provider Name (Legal Business Name): TITAN DEVELOPERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4095 SW 67TH AVE
MIAMI FL
33155-4757
US

IV. Provider business mailing address

4095 SW 67TH AVE
MIAMI FL
33155-4757
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-2000
  • Fax:
Mailing address:
  • Phone: 305-661-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. JESUS SUAREZ
Title or Position: PRESIDENT
Credential:
Phone: 305-903-2000