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General NPI Number Information
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NPI Number | 1043582497
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Entity Type | Organization
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Legal Business Name | RV MEDICAL CENTER, INC
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 3383 NW 7TH ST STE 313
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City | MIAMI
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State | FL
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Zip | 33125-4140
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Country | US
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Telephone | 305-392-0371
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Fax |
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Provider Business Mailing Address
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Address Line | 3383 NW 7TH ST STE 313
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City | MIAMI
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State | FL
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Zip | 33125-4140
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | REYNA L MORA
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Credential |
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Telephone | 305-392-0371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | AHCA HCC 9365
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License Number State | FL
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