Healthcare Provider Details

I. General information

NPI: 1093533721
Provider Name (Legal Business Name): ENVY SOUTH FLORIDA MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 SW 137TH AVE STE 94
MIAMI FL
33175-6361
US

IV. Provider business mailing address

2711 SW 137TH AVE STE 94
MIAMI FL
33175-6361
US

V. Phone/Fax

Practice location:
  • Phone: 786-951-9551
  • Fax: 786-936-5591
Mailing address:
  • Phone: 786-951-9551
  • Fax: 786-936-5591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSE L SANCHEZ BENITEZ
Title or Position: OWNER
Credential:
Phone: 786-951-9551