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General NPI Number Information
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NPI Number | 1003045055
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Entity Type | Organization
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Legal Business Name | MIAMI ACCIDENT CLINIC, INC
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Dates
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Enumeration Date | 07/13/2009
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 3727 SW 8TH ST STE 102
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City | CORAL GABLES
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State | FL
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Zip | 33134-3158
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Country | US
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Telephone | 786-380-6652
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Fax | 305-441-2509
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Provider Business Mailing Address
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Address Line | PO BOX 430746
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City | MIAMI
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State | FL
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Zip | 33243-0746
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Country | US
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Telephone | 786-380-6652
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Fax | 305-441-2509
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. JEANETTE DIAZ
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Credential | D.C
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Telephone | 786-380-6652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH9231
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License Number State | FL
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