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General NPI Number Information
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NPI Number | 1073758017
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Entity Type | Organization
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Legal Business Name | OTERO MEDICAL CENTERS INC
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 8212 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33144-2028
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Country | US
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Telephone | 305-444-7799
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Fax | 305-860-8255
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Provider Business Mailing Address
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Address Line | 8212 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33144-2028
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Country | US
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Telephone | 305-444-7799
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Fax | 305-860-8255
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Authorized Official
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Title or Position | CEO
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Name | DR. JUAN O. OTERO
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Credential | M.D.
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Telephone | 305-444-7799
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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 | ME77284
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME71343
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License Number State | FL
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