Healthcare Provider Details
I. General information
NPI: 1053738369
Provider Name (Legal Business Name): PHYSICIANS ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/25/2014
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10860 SW 88TH ST
MIAMI FL
33176-2680
US
IV. Provider business mailing address
7360 CORAL WAY SUITE 8
MIAMI FL
33155-1498
US
V. Phone/Fax
- Phone: 305-595-1300
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEVIN
FOX
Title or Position: PRESIDENT
Credential:
Phone: 305-266-1208