Healthcare Provider Details

I. General information

NPI: 1851055529
Provider Name (Legal Business Name): BETTERMED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16470 NE 10TH AVE
NORTH MIAMI BEACH FL
33162-3710
US

IV. Provider business mailing address

2103 CORAL WAY FL 2
CORAL GABLES FL
33145-2601
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-9988
  • Fax:
Mailing address:
  • Phone: 305-510-0877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. IVAN DYNAMO DE JESUS
Title or Position: MANAGING PARTNER
Credential:
Phone: 305-510-0877