Healthcare Provider Details

I. General information

NPI: 1962934067
Provider Name (Legal Business Name): MIAMI BEACH MEDICAL CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SW 8TH ST SUITE 101-103
MIAMI FL
33144-4400
US

IV. Provider business mailing address

1400 NW 107TH AVE STE 500
SWEETWATER FL
33172-2746
US

V. Phone/Fax

Practice location:
  • Phone: 305-534-0076
  • Fax:
Mailing address:
  • Phone: 305-534-0076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME58111
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSE D SUAREZ
Title or Position: CMO
Credential:
Phone: 305-534-0076