Healthcare Provider Details

I. General information

NPI: 1902585623
Provider Name (Legal Business Name): NEXT LEVEL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10251 SW 72ND ST STE 102
MIAMI FL
33173-2957
US

IV. Provider business mailing address

7772 DILIDO BLVD
MIRAMAR FL
33023-6402
US

V. Phone/Fax

Practice location:
  • Phone: 305-490-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY JOHNSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-308-5398