Healthcare Provider Details

I. General information

NPI: 1295951572
Provider Name (Legal Business Name): HILDA M BRITO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12260 SW 8TH ST SUITE 224
MIAMI FL
33184-1551
US

IV. Provider business mailing address

12260 SW 8TH ST SUITE 224
MIAMI FL
33184-1551
US

V. Phone/Fax

Practice location:
  • Phone: 305-220-6917
  • Fax: 305-220-6977
Mailing address:
  • Phone: 305-220-6917
  • Fax: 305-220-6977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME95342
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME95342
License Number StateFL

VIII. Authorized Official

Name: HILDA M BRITO
Title or Position: PRESIDENT
Credential: MD
Phone: 305-220-6917