=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033564083
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INTERNATIONAL RESEARCH PARTNERS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2016
-----------------------------------------------------
Last Update Date | 06/03/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3900 NW 79TH AVE STE 520
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33166-6560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-468-9455
-----------------------------------------------------
Fax | 305-468-9457
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3900 NW 79TH AVE STE 520
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33166-6560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-468-9455
-----------------------------------------------------
Fax | 305-468-9457
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MRS. MILAGROS AGOSTO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-468-9455
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1100X
-----------------------------------------------------
Taxonomy Name | Research Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------