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General NPI Number Information
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NPI Number | 1174908404
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Entity Type | Organization
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Legal Business Name | JADE MEDICAL CENTER, INC
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 2742 SW 8TH ST STE 11
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City | MIAMI
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State | FL
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Zip | 33135-4656
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Country | US
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Telephone | 305-642-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 2742 SW 8TH ST STE 11
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City | MIAMI
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State | FL
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Zip | 33135-4656
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Country | US
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Telephone | 305-642-4111
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Fax |
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Authorized Official
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Title or Position | BILLIER
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Name | MRS. EVELYN HERNANDEZ
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Credential |
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Telephone | 786-339-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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