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General NPI Number Information
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NPI Number | 1366787970
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Entity Type | Organization
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Legal Business Name | AZUR MEDICAL CENTER CO.
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Dates
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Enumeration Date | 12/07/2012
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Last Update Date | 02/19/2013
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Provider Practice Location Address
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Address Line | 330 SW 27TH AVE SUITE 403
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City | MIAMI
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State | FL
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Zip | 33135-2961
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Country | US
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Telephone | 786-522-5330
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Fax | 786-522-5331
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Provider Business Mailing Address
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Address Line | 330 SW 27TH AVE SUITE 403
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City | MIAMI
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State | FL
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Zip | 33135-2961
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Country | US
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Telephone | 786-522-5330
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Fax | 786-522-5331
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAFAEL GARCIA
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Credential | MD
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Telephone | 786-522-5330
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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 | ME105065
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License Number State | FL
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