Healthcare Provider Details

I. General information

NPI: 1578143756
Provider Name (Legal Business Name): CDR MAGUIRE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9130 S DADELAND BLVD STE 1504
MIAMI FL
33156-7850
US

IV. Provider business mailing address

9130 S DADELAND BLVD STE 1504
MIAMI FL
33156-7850
US

V. Phone/Fax

Practice location:
  • Phone: 606-312-7733
  • Fax: 606-312-7733
Mailing address:
  • Phone: 606-312-7733
  • Fax: 606-312-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARLOS A DUART
Title or Position: PTD
Credential:
Phone: 606-312-7733