Healthcare Provider Details

I. General information

NPI: 1376327643
Provider Name (Legal Business Name): MEDARRIVE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 BRICKELL KEY DR STE 700
MIAMI FL
33131-2649
US

IV. Provider business mailing address

601 BRICKELL KEY DR STE 700
MIAMI FL
33131-2649
US

V. Phone/Fax

Practice location:
  • Phone: 866-735-5091
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: PETER SAMUEL
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 866-735-5091