Healthcare Provider Details

I. General information

NPI: 1508468349
Provider Name (Legal Business Name): ENDOCONSULTANTS MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7887 N KENDALL DR STE 215
MIAMI FL
33156-7758
US

IV. Provider business mailing address

7887 N KENDALL DR STE 215
MIAMI FL
33156-7758
US

V. Phone/Fax

Practice location:
  • Phone: 786-433-2450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEX MANZANO
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 786-525-3887