Healthcare Provider Details

I. General information

NPI: 1780287847
Provider Name (Legal Business Name): OPA MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/27/2020
Certification Date: 11/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 NE 163RD ST STE A
NORTH MIAMI BEACH FL
33162-4805
US

IV. Provider business mailing address

1865 NE 163RD ST STE A
NORTH MIAMI BEACH FL
33162-4805
US

V. Phone/Fax

Practice location:
  • Phone: 305-948-9525
  • Fax: 305-948-9518
Mailing address:
  • Phone: 305-948-9525
  • Fax: 305-948-9518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANK PEDRIANES
Title or Position: CEO
Credential:
Phone: 305-948-9525