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General NPI Number Information
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NPI Number | 1013255751
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Entity Type | Organization
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Legal Business Name | OK MEDICAL CENTER INC
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 1414 NW 107TH AVE STE 203
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City | DORAL
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State | FL
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Zip | 33172-2741
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Country | US
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Telephone | 305-470-7555
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Fax | 305-470-0011
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Provider Business Mailing Address
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Address Line | 1414 NW 107TH AVE STE 203
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City | DORAL
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State | FL
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Zip | 33172-2741
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Country | US
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Telephone | 305-470-7555
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Fax | 305-470-0011
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Authorized Official
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Title or Position | MASSAGE TERAPEUTIC
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Name | OLGA E QUINONES
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Credential |
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Telephone | 305-470-7555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | MA44223
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License Number State | FL
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