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General NPI Number Information
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NPI Number | 1346356847
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Entity Type | Organization
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Legal Business Name | BIRD RD MEDICAL CENTER INC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 8485 SW 40TH STREET 102
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City | MIAMI
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State | FL
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Zip | 33155-3262
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Country | US
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Telephone | 305-551-3412
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Fax | 305-551-1945
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Provider Business Mailing Address
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Address Line | 8485 SW 40TH STREET 102
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City | MIAMI
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State | FL
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Zip | 33155-3262
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Country | US
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Telephone | 305-551-3412
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Fax | 305-551-1945
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | DORA Q REYES
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Credential |
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Telephone | 305-551-3412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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