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General NPI Number Information
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NPI Number | 1215961537
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Entity Type | Organization
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Legal Business Name | C & S MEDICAL CLINIC, CORP
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7171 CORAL WAY SUITE 305
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City | MIAMI
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State | FL
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Zip | 33155-1449
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Country | US
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Telephone | 305-264-2977
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Fax | 305-264-2979
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Provider Business Mailing Address
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Address Line | 7171 CORAL WAY SUITE 305
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City | MIAMI
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State | FL
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Zip | 33155-1449
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Country | US
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Telephone | 305-264-2977
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Fax | 305-264-2979
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HUGO R RIVAS
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Credential |
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Telephone | 305-264-2977
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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 | ME37973
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License Number State | FL
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