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General NPI Number Information
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NPI Number | 1073692505
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Entity Type | Organization
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Legal Business Name | COURTESY MEDICAL GROUP INC.
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 8080 W FLAGLER ST SUITE 3D
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City | MIAMI
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State | FL
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Zip | 33144-2100
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Country | US
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Telephone | 305-262-8252
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Fax | 305-262-4122
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Provider Business Mailing Address
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Address Line | 8080 W FLAGLER ST SUITE 3D
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City | MIAMI
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State | FL
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Zip | 33144-2100
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Country | US
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Telephone | 305-262-8252
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Fax | 305-262-4122
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TERESA CAYRO
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Credential |
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Telephone | 305-262-8252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 363AM0700X
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | FL
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