Healthcare Provider Details

I. General information

NPI: 1093472557
Provider Name (Legal Business Name): TU SALUD MEDICAL CENTERS III LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 NW 17TH AVE
MIAMI FL
33125-2327
US

IV. Provider business mailing address

900 PARK CENTRE BLVD STE 400A
MIAMI GARDENS FL
33169-5371
US

V. Phone/Fax

Practice location:
  • Phone: 305-912-8603
  • Fax: 305-907-5343
Mailing address:
  • Phone: 305-912-8603
  • Fax: 305-907-5343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YUNIEL REY DEL TORO
Title or Position: PRESIDENT
Credential:
Phone: 305-912-8603