Healthcare Provider Details

I. General information

NPI: 1407703085
Provider Name (Legal Business Name): MCJ SURGICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16819 SW 115TH AVE
MIAMI FL
33157-3984
US

IV. Provider business mailing address

16819 SW 115TH AVE
MIAMI FL
33157-3984
US

V. Phone/Fax

Practice location:
  • Phone: 786-237-7282
  • Fax:
Mailing address:
  • Phone: 786-237-7282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MARIA D GALINDO COVAS
Title or Position: MEDICAL DIRECTOR
Credential: APRN
Phone: 786-237-7282