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General NPI Number Information
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NPI Number | 1194919415
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Entity Type | Organization
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Legal Business Name | D & J MEDICAL HEALTH INC
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 10550 NW 77TH CT SUITE 313
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-7084
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Country | US
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Telephone | 305-824-5005
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Fax | 305-824-5020
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Provider Business Mailing Address
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Address Line | 10550 NW 77TH CT SUITE 313
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-7084
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Country | US
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Telephone | 305-824-5020
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Fax | 305-824-5005
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA C FAVELO
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Credential |
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Telephone | 305-824-5020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC6699
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License Number State | FL
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