Healthcare Provider Details

I. General information

NPI: 1174009146
Provider Name (Legal Business Name): HEALTHCARE MANAGEMENT RESOURCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 BRICKELL AVENUE SUITE T-206
MIAMI FL
33129-1221
US

IV. Provider business mailing address

1581 BRICKELL AVENUE SUITE T-206
MIAMI FL
33129-1221
US

V. Phone/Fax

Practice location:
  • Phone: 305-608-2800
  • Fax:
Mailing address:
  • Phone: 305-608-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN E CIANCIULLI
Title or Position: OWNER/ MANAGING MEMBER
Credential:
Phone: 305-608-2800