Healthcare Provider Details

I. General information

NPI: 1275797003
Provider Name (Legal Business Name): ALL CREDENTIALING SOLUTIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15645 SW 90TH TER
MIAMI FL
33196-1161
US

IV. Provider business mailing address

15645 SW 90TH TERRACE
MIAMI FL
33196
US

V. Phone/Fax

Practice location:
  • Phone: 786-525-5796
  • Fax: 305-383-7408
Mailing address:
  • Phone: 786-525-5796
  • Fax: 305-383-7408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MR. JORGE GARCIA
Title or Position: CREDENTIALING SPECIALISTS
Credential:
Phone: 786-525-5796