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General NPI Number Information
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NPI Number | 1285751974
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Entity Type | Organization
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Legal Business Name | MIAMI VA MEDICAL CENTER
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1201 NW 16TH ST
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-575-3105
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Fax |
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Provider Business Mailing Address
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Address Line | 16250 NW 19TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1743
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Country | US
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Telephone | 305-575-3105
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Fax |
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Authorized Official
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Title or Position | RN MSN NURSE MANAGER
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Name | JOSE A MARTINEZ
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Credential |
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Telephone | 305-575-3105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | RN 9214248
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License Number State | FL
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