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General NPI Number Information
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NPI Number | 1265033823
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Entity Type | Organization
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Legal Business Name | BLESS MEDICAL CENTER OF NMB LLC
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 1400 NE MIAMI GARDENS DR STE 209
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-4844
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Country | US
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Telephone | 954-864-6401
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Fax |
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Provider Business Mailing Address
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Address Line | 440 E SAMPLE RD STE 107
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4432
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Country | US
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Telephone | 954-864-6401
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Fax |
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Authorized Official
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Title or Position | COO
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Name | OSVALDO MARTINEZ
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Credential |
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Telephone | 954-864-6401
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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 |
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License Number State |
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