Healthcare Provider Details

I. General information

NPI: 1326034331
Provider Name (Legal Business Name): STREBOR MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2005
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 NE 125TH ST SUITE 306
NORTH MIAMI FL
33161-5015
US

IV. Provider business mailing address

1175 NE 125TH ST SUITE 306
NORTH MIAMI FL
33161-5015
US

V. Phone/Fax

Practice location:
  • Phone: 305-895-3231
  • Fax:
Mailing address:
  • Phone: 305-895-3231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberME0076863
License Number StateFL

VIII. Authorized Official

Name: DR. VICTORIA MARIE ROBERTS
Title or Position: PHYSICIAN, CEO
Credential: M.D.
Phone: 305-895-3231