Healthcare Provider Details

I. General information

NPI: 1407044043
Provider Name (Legal Business Name): VMD GYN ONCOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 AVIATION AVE SUITE 700
MIAMI FL
33133-4741
US

IV. Provider business mailing address

3225 AVIATION AVE
MIAMI FL
33133-4741
US

V. Phone/Fax

Practice location:
  • Phone: 305-273-4641
  • Fax: 305-273-1497
Mailing address:
  • Phone: 305-273-4641
  • Fax: 305-273-1497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANCISCO LEON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 305-273-4641