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General NPI Number Information
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NPI Number | 1114497492
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Entity Type | Organization
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Legal Business Name | SOS MEDICAL CENTER CORP
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 6445 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-4813
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Country | US
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Telephone | 305-968-3666
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Fax | 786-598-7449
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Provider Business Mailing Address
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Address Line | 6445 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-4813
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Country | US
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Telephone | 305-968-3666
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CARLOS INFANTE
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Credential |
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Telephone | 305-968-3666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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