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General NPI Number Information
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NPI Number | 1376204420
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Entity Type | Organization
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Legal Business Name | AMEDICAL LUXURY
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Dates
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Enumeration Date | 12/30/2021
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 117 E 41ST ST
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City | HIALEAH
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State | FL
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Zip | 33013-2235
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Country | US
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Telephone | 786-407-4103
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Fax |
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Provider Business Mailing Address
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Address Line | 117 E 41ST ST
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City | HIALEAH
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State | FL
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Zip | 33013-2235
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Country | US
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Telephone | 786-407-4103
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Fax |
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Authorized Official
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Title or Position | CEO/PRACTITIONER
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Name | MRS. HEATHER ALEXANDRA PRECIADO
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Credential | FNP-C
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Telephone | 786-362-4338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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