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General NPI Number Information
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NPI Number | 1346419330
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Entity Type | Organization
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Legal Business Name | MEDICAL PROFESSIONAL SERVICES
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 2500 SW 107TH AVE SUITE 41
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City | MIAMI
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State | FL
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Zip | 33165-2470
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Country | US
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Telephone | 305-228-1274
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Fax | 305-228-1298
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Provider Business Mailing Address
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Address Line | 2500 SW 107TH AVE SUITE 41
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City | MIAMI
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State | FL
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Zip | 33165-2470
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Country | US
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Telephone | 305-228-1274
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Fax | 305-228-1298
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRISMEL MARQUEZ
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Credential |
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Telephone | 305-228-1274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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