Healthcare Provider Details

I. General information

NPI: 1740519040
Provider Name (Legal Business Name): UNIVERSITY OF MIAMI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2009
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 12TH AVE SUITE # 2010
MIAMI FL
33136-1005
US

IV. Provider business mailing address

1601 NW 12TH AVE SUITE # 2010
MIAMI FL
33136-1005
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-5937
  • Fax: 305-243-6921
Mailing address:
  • Phone: 305-243-5937
  • Fax: 305-243-6921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: GEMMA ROMILLO
Title or Position: EXECUTIVE DIRECTOR OF BILLING COMPL
Credential:
Phone: 305-243-6837