Healthcare Provider Details
I. General information
NPI: 1881632776
Provider Name (Legal Business Name): NEW FUTURE MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2301 NW 7TH ST SUITE C
MIAMI FL
33125-3299
US
IV. Provider business mailing address
2301 NW 7TH ST SUITE C
MIAMI FL
33125-3299
US
V. Phone/Fax
- Phone: 786-709-6754
- Fax: 305-805-8566
- Phone: 786-709-6754
- Fax: 305-805-8566
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | 604666-8 |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
JULIAN
REYNALDO
GONZALEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-709-6754