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General NPI Number Information
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NPI Number | 1386930949
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Entity Type | Organization
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Legal Business Name | MIAMI VETERANS HOSPITAL
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 1201 NW 16TH ST SUITE C808 ROUTING: 112
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-575-3166
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 NW 16TH ST SUITE C808 ROUTING: 112
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-575-3166
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Fax |
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Authorized Official
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Title or Position | RESIDENCY DIRECTOR
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Name | DR. GARY ROTHENBERG
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Credential | DPM
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Telephone | 305-575-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | PR219
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License Number State | FL
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