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General NPI Number Information
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NPI Number | 1104396688
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Entity Type | Organization
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Legal Business Name | NIMEL MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 10821 NW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33167-3407
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Country | US
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Telephone | 305-381-0193
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Fax | 305-437-7625
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Provider Business Mailing Address
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Address Line | 10821 NW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33167-3407
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Country | US
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Telephone | 305-381-0193
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Fax | 305-437-7625
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFAEL PEREZ GONZALEZ
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Credential | MD
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Telephone | 786-516-4221
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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 |
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License Number State |
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