Healthcare Provider Details

I. General information

NPI: 1881881241
Provider Name (Legal Business Name): FERTILITY & IVF CENTER OF MIAMI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 103
MIAMI FL
33176-2197
US

IV. Provider business mailing address

8950 N KENDALL DR STE 103
MIAMI FL
33176-2197
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-4013
  • Fax: 305-596-4557
Mailing address:
  • Phone: 305-596-4013
  • Fax: 305-596-4557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHAEL HARRIS JACOBS
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 305-596-4013