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General NPI Number Information
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NPI Number | 1346294949
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Entity Type | Organization
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Legal Business Name | ATHENNAS MEDICAL CENTER, INC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 633 NE 167TH ST SUITE 1111
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-2442
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Country | US
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Telephone | 305-493-4659
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Fax | 305-493-4660
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Provider Business Mailing Address
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Address Line | 633 NE 167TH ST SUITE 1111
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-2442
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Country | US
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Telephone | 305-493-4659
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Fax | 305-493-4660
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DAHIMY AVILA
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Credential |
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Telephone | 305-493-4659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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