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General NPI Number Information
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NPI Number | 1043626765
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Entity Type | Organization
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Legal Business Name | HEAD AND NECK TREATMENT CENTER OF MIAMI INC
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 07/19/2014
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Provider Practice Location Address
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Address Line | 757 ARTHUR GODFREY RD
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3413
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Country | US
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Telephone | 305-672-4444
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Fax | 305-672-8997
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Provider Business Mailing Address
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Address Line | 757 ARTHUR GODFREY RD
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3413
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Country | US
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Telephone | 305-672-4444
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Fax | 305-672-8997
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAMID NASSERY
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Credential | DMD
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Telephone | 305-552-9102
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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 | ME50634
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License Number State | FL
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