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General NPI Number Information
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NPI Number | 1386840189
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Entity Type | Organization
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Legal Business Name | 167TH STREET MEDICAL CENTER INC
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 909 N MIAMI BEACH BLVD SUITE 101
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3712
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Country | US
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Telephone | 305-945-1288
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Fax | 305-949-7479
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Provider Business Mailing Address
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Address Line | 909 N MIAMI BEACH BLVD SUITE 101
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-3712
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Country | US
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Telephone | 305-945-1288
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Fax | 305-949-7479
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Authorized Official
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Title or Position | DOCTOR, OWNER
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Name | DR. YUKHANAN BENJAMIN
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Credential | M.D., PH.D
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Telephone | 305-945-1288
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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 | FL
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