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General NPI Number Information
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NPI Number | 1124176185
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Entity Type | Organization
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Legal Business Name | US COAST GUARD
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 100 MACARTHUR CSWY
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City | MIAMI
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State | FL
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Zip | 33139-5101
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Country | US
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Telephone | 305-535-4535
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 SW 103RD AVE
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City | MIAMI
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State | FL
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Zip | 33165-4947
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Country | US
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Telephone | 305-735-2276
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Fax |
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Authorized Official
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Title or Position | CERTIFIED MEDICAL ASSISTANT
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Name | NYREE NATASHA COOKE
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Credential | CMA
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Telephone | 305-535-4535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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