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General NPI Number Information
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NPI Number | 1063201234
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Entity Type | Organization
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Legal Business Name | GESA MEDICAL CENTER CORP.
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 3850 SW 87TH AVE STE 305
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City | MIAMI
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State | FL
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Zip | 33165-5474
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Country | US
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Telephone | 305-845-7787
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Fax | 786-936-5583
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Provider Business Mailing Address
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Address Line | 2204 SW 106TH CT
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City | MIAMI
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State | FL
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Zip | 33165-7945
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Country | US
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Telephone | 786-836-9014
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEMA PORRAS
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Credential |
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Telephone | 786-836-9014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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