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General NPI Number Information
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NPI Number | 1275736548
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Entity Type | Organization
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Legal Business Name | WEST MIAMI HEALTH CENTER CORP
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | 1425 SW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33145-1234
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Country | US
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Telephone | 786-338-9243
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Fax | 786-264-1383
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Provider Business Mailing Address
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Address Line | 1425 SW 27TH AVE
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City | MIAMI
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State | FL
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Zip | 33145-1234
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Country | US
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Telephone | 786-338-9243
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Fax | 783-264-1383
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER GOMEZ-ESTEVES
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Credential |
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Telephone | 786-338-9243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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