Healthcare Provider Details

I. General information

NPI: 1467681445
Provider Name (Legal Business Name): BISCAYNE WELLNESS MEDICAL INSTITUTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2009
Last Update Date: 07/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13899 BISCAYNE BLVD SUITE 155
NORTH MIAMI BEACH FL
33181-1600
US

IV. Provider business mailing address

13899 BISCAYNE BLVD SUITE 155
NORTH MIAMI BEACH FL
33181-1600
US

V. Phone/Fax

Practice location:
  • Phone: 305-816-6733
  • Fax: 305-808-3416
Mailing address:
  • Phone: 305-816-6733
  • Fax: 305-808-3416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIE CARMEL DOSSOUS
Title or Position: OFFICE MANAGER
Credential:
Phone: 954-274-0847