Healthcare Provider Details

I. General information

NPI: 1275831737
Provider Name (Legal Business Name): PMS 4 DOCS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 03/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3692A GRAND AVE
MIAMI FL
33133-4953
US

IV. Provider business mailing address

1234 S DIXIE HWY STE 324
CORAL GABLES FL
33146-2902
US

V. Phone/Fax

Practice location:
  • Phone: 305-662-4477
  • Fax: 305-740-3390
Mailing address:
  • Phone: 305-662-4477
  • Fax: 305-740-3390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. ALFREDO MESA
Title or Position: PRESIDENT
Credential:
Phone: 305-662-4477