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General NPI Number Information
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NPI Number | 1184021115
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Entity Type | Organization
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Legal Business Name | BORROTO CLINIC AND TRANSPORTATION CORP
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 6850 SW 24TH ST STE 501
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City | MIAMI
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State | FL
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Zip | 33155-1763
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Country | US
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Telephone | 305-764-8866
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Fax | 789-534-8718
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Provider Business Mailing Address
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Address Line | 6850 SW 24TH ST STE 501
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City | MIAMI
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State | FL
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Zip | 33155-1763
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Country | US
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Telephone | 305-764-8866
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Fax | 789-534-8718
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | BLANCA GONZALEZ
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Credential | MD
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Telephone | 305-764-8866
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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 | ME106369
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License Number State | FL
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