Healthcare Provider Details

I. General information

NPI: 1760877070
Provider Name (Legal Business Name): CENTER FOR DIGESTIVE MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7887 N KENDALL DR SUITE 101
MIAMI FL
33156-7427
US

IV. Provider business mailing address

7887 N KENDALL DR SUITE 101
MIAMI FL
33156-7427
US

V. Phone/Fax

Practice location:
  • Phone: 305-825-6729
  • Fax: 305-273-6520
Mailing address:
  • Phone: 305-825-6729
  • Fax: 305-273-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: VICTOR M PINA
Title or Position: PHYSICIAN PARTNER
Credential: MD
Phone: 305-825-6729