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General NPI Number Information
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NPI Number | 1245480623
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Entity Type | Organization
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Legal Business Name | PMC PHYSICIAN ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 12550 BISCAYNE BLVD STE 500
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2544
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Country | US
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Telephone | 305-868-7180
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Fax |
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Provider Business Mailing Address
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Address Line | 12550 BISCAYNE BLVD STE 500
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2544
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Country | US
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Telephone | 305-868-7180
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Fax |
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Authorized Official
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Title or Position | MNG. MBR
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Name | MR. SPENCER ANGEL
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Credential |
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Telephone | 305-868-7180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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