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General NPI Number Information
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NPI Number | 1275343246
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL FIRST CORP
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 4888 NW 183RD ST STE 205
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-2942
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Country | US
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Telephone | 786-676-4512
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Fax |
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Provider Business Mailing Address
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Address Line | 4888 NW 183RD ST STE 205
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-2942
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Country | US
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Telephone | 786-676-4512
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERNANDO FANDINO SENDE
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Credential | M.D
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Telephone | 786-676-4512
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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 |
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License Number State |
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