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General NPI Number Information
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NPI Number | 1083982649
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Entity Type | Organization
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Legal Business Name | WOMEN AND TEENS HEALTHCARE INC
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Dates
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Enumeration Date | 12/09/2011
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 16876 NE 19TH AVE
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3108
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Country | US
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Telephone | 305-895-5555
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Fax | 305-947-0061
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Provider Business Mailing Address
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Address Line | 16876 NE 19TH AVE
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3108
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Country | US
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Telephone | 305-895-5555
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Fax | 305-947-0061
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Authorized Official
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Title or Position | MD
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Name | DR. SYLVESTER BRAITHWAITE
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Credential |
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Telephone | 305-895-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME062140
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License Number State | FL
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