Healthcare Provider Details

I. General information

NPI: 1801378617
Provider Name (Legal Business Name): HELLO DR M LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6140 SW 70TH ST
SOUTH MIAMI FL
33143-3419
US

IV. Provider business mailing address

2475 NW 16TH STREET RD
MIAMI FL
33125-1299
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7577
  • Fax: 305-284-7761
Mailing address:
  • Phone: 407-221-2313
  • Fax: 305-284-7761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT MORADIAN
Title or Position: PHYSICIAN/OWNER
Credential: D.O.
Phone: 407-221-2313