Healthcare Provider Details
I. General information
NPI: 1124278312
Provider Name (Legal Business Name): RESEARCH AND SERVICE FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2008
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3800 NW 132ND ST
OPA LOCKA FL
33054-4552
US
IV. Provider business mailing address
3800 NW 132ND ST
OPA LOCKA FL
33054-4552
US
V. Phone/Fax
- Phone: 305-685-9331
- Fax: 305-688-5852
- Phone: 305-685-9331
- Fax: 305-688-5852
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROLANDO
J
MUHLIG
Title or Position: REGISTER AGENT
Credential: PHD
Phone: 305-685-9331