Healthcare Provider Details

I. General information

NPI: 1346460193
Provider Name (Legal Business Name): FLORIDA INTERNATIONAL UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 SW 8TH ST FIU UNIVERSITY HEALTH SERVICES COMPLEX 280
MIAMI FL
33199-0001
US

IV. Provider business mailing address

11200 SW 8TH ST FIU UNIVERSITY HEALTH SERVICES COMPLEX 280
MIAMI FL
33199-0001
US

V. Phone/Fax

Practice location:
  • Phone: 305-348-3080
  • Fax: 305-348-6655
Mailing address:
  • Phone: 305-348-3080
  • Fax: 305-348-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License NumberME0037619
License Number StateFL

VIII. Authorized Official

Name: DR. ROBERT FRANKLIN DOLLINGER
Title or Position: EXECUTIVE DIRECTOR
Credential: MD
Phone: 305-348-3080