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General NPI Number Information
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NPI Number | 1376703561
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Entity Type | Organization
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Legal Business Name | MONTECRISTO MEDICAL CENTER CORP
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 1653 NW 34TH ST
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City | MIAMI
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State | FL
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Zip | 33142-5584
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Country | US
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Telephone | 754-224-8870
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Fax |
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Provider Business Mailing Address
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Address Line | 1653 NW 34TH ST
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City | MIAMI
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State | FL
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Zip | 33142-5584
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OT
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Name | VIDA JAMES
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Credential |
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Telephone | 754-224-8870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | HCC6894
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License Number State | FL
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