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General NPI Number Information
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NPI Number | 1003160052
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Entity Type | Organization
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Legal Business Name | ORP REFLEXION MEDICAL CENTER
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 3912 W 12TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4105
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Country | US
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Telephone | 786-391-0596
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Fax | 786-391-0597
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Provider Business Mailing Address
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Address Line | 3912 W 12TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4105
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Country | US
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Telephone | 786-391-0596
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Fax | 786-391-0597
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Authorized Official
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Title or Position | OWNER
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Name | ISABEL NARANJO
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Credential | MA
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Telephone | 786-391-0596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | HCC10259
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License Number State | FL
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