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General NPI Number Information
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NPI Number | 1326457086
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Entity Type | Organization
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Legal Business Name | M & Y MEDICAL OFFICE CORP
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 1518 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-3159
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Country | US
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Telephone | 786-384-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 1518 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-3159
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Country | US
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Telephone | 786-384-0020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGINA ARES
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Credential |
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Telephone | 786-384-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | MA 66715
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License Number State | FL
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