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General NPI Number Information
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NPI Number | 1306156278
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Entity Type | Organization
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Legal Business Name | PMC KENDALL, LLC
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 7800 SW 87TH AVE
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City | MIAMI
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State | FL
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Zip | 33173-3570
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Country | US
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Telephone | 305-598-8787
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Fax | 305-598-8680
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Provider Business Mailing Address
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Address Line | 80 SW 8TH ST STE 2000
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City | MIAMI
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State | FL
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Zip | 33130-3038
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Country | US
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Telephone | 305-868-7180
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Fax | 305-675-0400
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Authorized Official
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Title or Position | MNG MBR
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Name | SPENCER ANGEL
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Credential |
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Telephone | 305-868-7180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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