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General NPI Number Information
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NPI Number | 1396029419
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Entity Type | Organization
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Legal Business Name | CAPOTE'S INTERNAL MEDICINE LLC
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 937 SW 122ND AVE
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City | MIAMI
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State | FL
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Zip | 33184-2406
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Country | US
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Telephone | 813-260-0706
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Fax |
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Provider Business Mailing Address
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Address Line | 937 SW 122ND AVE
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City | MIAMI
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State | FL
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Zip | 33184-2406
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Country | US
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Telephone | 813-260-0706
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PAVEL CAPOTE
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Credential | MD
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Telephone | 813-260-0706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME104299
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License Number State | FL
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