Healthcare Provider Details

I. General information

NPI: 1124544465
Provider Name (Legal Business Name): RIEL ALLERGY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 08/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7969 NW 2ND ST
MIAMI FL
33126
US

IV. Provider business mailing address

7969 NW 2ND ST
MIAMI FL
33126-8018
US

V. Phone/Fax

Practice location:
  • Phone: 786-637-0126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: EDUARDO A MARCELLINI
Title or Position: PRESIDENT
Credential:
Phone: 786-637-0126