Healthcare Provider Details

I. General information

NPI: 1649226143
Provider Name (Legal Business Name): MYL MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27501 S DIXIE HWY
NARANJA FL
33032-8235
US

IV. Provider business mailing address

27501 S DIXIE HWY
NARANJA FL
33032-8235
US

V. Phone/Fax

Practice location:
  • Phone: 305-248-1402
  • Fax:
Mailing address:
  • Phone: 305-248-1402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS NARVAEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-248-1402