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General NPI Number Information
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NPI Number | 1154209344
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Entity Type | Organization
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Legal Business Name | GLS PROHEALTH MEDICAL CENTER INC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 9600 SW 8TH ST STE 25
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City | MIAMI
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State | FL
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Zip | 33174-2968
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Country | US
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Telephone | 786-417-9485
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Fax |
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Provider Business Mailing Address
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Address Line | 11825 SW 104TH TER
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City | MIAMI
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State | FL
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Zip | 33186-3958
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Country | US
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Telephone | 786-417-9485
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Fax |
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Authorized Official
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Title or Position | PRES/OWNER
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Name | GUILLERMO ATILIO PINELO
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Credential | ACN
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Telephone | 786-417-9485
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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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