Healthcare Provider Details

I. General information

NPI: 1386183580
Provider Name (Legal Business Name): DR2GO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8860 SW 123RD CT
MIAMI FL
33186-4152
US

IV. Provider business mailing address

8860 SW 123RD CT
MIAMI FL
33186-4152
US

V. Phone/Fax

Practice location:
  • Phone: 305-951-2027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AMPARO BENITEZ BROOME
Title or Position: OWNER
Credential: DO
Phone: 305-951-2027