Healthcare Provider Details
I. General information
NPI: 1407818792
Provider Name (Legal Business Name): COVIMED INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8390 W FLAGLER ST SUITE 221
MIAMI FL
33144-2039
US
IV. Provider business mailing address
8390 W FLAGLER ST SUITE 221
MIAMI FL
33144-2039
US
V. Phone/Fax
- Phone: 305-226-5574
- Fax: 305-221-9066
- Phone: 305-226-5574
- Fax: 305-221-9066
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RUBEN
T
PARADELA
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-226-5574