Healthcare Provider Details

I. General information

NPI: 1508635335
Provider Name (Legal Business Name): DBS MEDICAL CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/21/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 NW 107 AVENUE SUITE 112A
MIAMI FL
33172
US

IV. Provider business mailing address

2100 NW 107 AVENUE SUITE 112A
MIAMI FL
33172
US

V. Phone/Fax

Practice location:
  • Phone: 305-594-5999
  • Fax:
Mailing address:
  • Phone: 305-594-5999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: OSMAR ALARCON SEGURA
Title or Position: CORP MGER
Credential: APRN
Phone: 305-594-5999