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General NPI Number Information
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NPI Number | 1295519981
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Entity Type | Organization
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Legal Business Name | ORANGE MEDICAL AND RESEARCH CORPORATION
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 5245 NW 36TH ST STE 5257
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5958
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Country | US
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Telephone | 305-764-4139
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Fax |
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Provider Business Mailing Address
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Address Line | 5245 NW 36TH ST STE 5257
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5958
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Country | US
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Telephone | 305-764-4139
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. OSMANY RICARDO AVILA
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Credential |
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Telephone | 305-794-4139
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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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