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General NPI Number Information
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NPI Number | 1043293368
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Entity Type | Organization
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Legal Business Name | CORAL GABLES ANESTHESIA ASSOCIATION CORP
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 2410 SW 63RD AVE
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City | MIAMI
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State | FL
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Zip | 33155-3062
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Country | US
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Telephone | 305-661-5597
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Fax | 305-661-3549
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Provider Business Mailing Address
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Address Line | PO BOX 816759
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City | HOLLYWOOD
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State | FL
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Zip | 33081-0759
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Country | US
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Telephone | 305-674-1233
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Fax | 954-964-6084
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAISY MACIAS
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Credential | M.D.
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Telephone | 954-964-2450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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