Healthcare Provider Details

I. General information

NPI: 1720293665
Provider Name (Legal Business Name): UNIVERSITY HEALTH SERVICES-FLORIDA INTERNATIONAL UNIVERSITY-BBC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 NE 151 STREET
N. MIAMI FL
33181-3605
US

IV. Provider business mailing address

3000 NE 151ST ST
NORTH MIAMI FL
33181-3605
US

V. Phone/Fax

Practice location:
  • Phone: 305-919-5620
  • Fax: 305-919-5314
Mailing address:
  • Phone: 305-919-5620
  • Fax: 305-919-5314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number521209127
License Number StateFL

VIII. Authorized Official

Name: MRS. ELVIRA VELEZ
Title or Position: DIRECTOR, HEALTH ADMINISTRATION
Credential: NURSE PRACTITIONER
Phone: 305-919-5620