Healthcare Provider Details

I. General information

NPI: 1730126186
Provider Name (Legal Business Name): QUALMED OF MIAMI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 NW 17TH AVE
MIAMI FL
33142-6631
US

IV. Provider business mailing address

2901 NW 17TH AVE
MIAMI FL
33142-6631
US

V. Phone/Fax

Practice location:
  • Phone: 305-633-3015
  • Fax: 305-634-9118
Mailing address:
  • Phone: 305-633-3015
  • Fax: 305-634-9118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MS. SANDRA MARIA PALACIO
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 305-398-0807