Healthcare Provider Details

I. General information

NPI: 1982097366
Provider Name (Legal Business Name): MEDICAL EXCELLENT THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2015
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6017 SW 8TH ST
WEST MIAMI FL
33144-5039
US

IV. Provider business mailing address

6017 SW 8TH ST
WEST MIAMI FL
33144-5039
US

V. Phone/Fax

Practice location:
  • Phone: 786-878-0600
  • Fax: 720-863-2728
Mailing address:
  • Phone: 786-878-0600
  • Fax: 720-863-2728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: OSQUIEL MARTINEZ
Title or Position: OWNER
Credential:
Phone: 786-878-0600