Healthcare Provider Details
I. General information
NPI: 1679804835
Provider Name (Legal Business Name): ERMD EMERGENCY ROOM MEDICAL DOCTORS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2010
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10621 N KENDALL DR SUITE 101
MIAMI FL
33176-8708
US
IV. Provider business mailing address
PO BOX 650308
MIAMI FL
33265-0308
US
V. Phone/Fax
- Phone: 305-229-3848
- Fax: 305-220-4578
- Phone: 305-229-3848
- Fax: 305-220-4578
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | ME0064467 |
| License Number State | FL |
VIII. Authorized Official
Name:
VENUS
DE FERIA
Title or Position: ASSISTANT OFFICE MANAGER
Credential:
Phone: 305-229-3848