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General NPI Number Information
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NPI Number | 1003338138
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Entity Type | Organization
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Legal Business Name | WK MEDICAL CENTER CORP
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 13304 SW 128TH ST
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City | MIAMI
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State | FL
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Zip | 33186-5899
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Country | US
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Telephone | 54-249-0603
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Fax | 305-363-4412
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Provider Business Mailing Address
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Address Line | 13304 SW 128TH ST
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City | MIAMI
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State | FL
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Zip | 33186-5899
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Country | US
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Telephone | 786-227-6498
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Fax | 305-570-2604
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDEL QUINTERO
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Credential |
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Telephone | 305-424-9060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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