Healthcare Provider Details

I. General information

NPI: 1669888509
Provider Name (Legal Business Name): UNIVERSITY OF MIAMI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 14TH ST SUITE 609
MIAMI FL
33136-2137
US

IV. Provider business mailing address

1150 NW 14TH ST SUITE 609
MIAMI FL
33136-2137
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6732
  • Fax: 305-243-4678
Mailing address:
  • Phone: 305-243-6732
  • Fax: 305-243-4678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: CESIA A SANCHEZ
Title or Position: PROVIDER ENROLLMENT MANAGER
Credential:
Phone: 305-243-6837