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General NPI Number Information
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NPI Number | 1356439608
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Entity Type | Organization
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Legal Business Name | MEDICAL PROFESSIONALS OF MIAMI, INC.
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 760 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-2075
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Country | US
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Telephone | 305-444-6167
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Fax | 305-444-4841
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Provider Business Mailing Address
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Address Line | 760 PONCE DE LEON BLVD
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City | CORAL GABLES
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State | FL
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Zip | 33134-2075
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Country | US
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Telephone | 305-444-6167
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Fax | 305-444-4841
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILFRED BRACERAS
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Credential |
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Telephone | 305-863-8860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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