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General NPI Number Information
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NPI Number | 1407004427
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Entity Type | Organization
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Legal Business Name | MIAMI HAND, PLASTIC & RECONSTRUCTIVE CENTER LLC
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 2750 S DOUGLAS RD 2ND FLOOR
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City | COCONUT GROVE
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State | FL
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Zip | 33133-2764
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Country | US
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Telephone | 305-426-3779
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Fax | 305-925-8100
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Provider Business Mailing Address
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Address Line | 2750 S DOUGLAS RD 2ND FLOOR
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City | COCONUT GROVE
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State | FL
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Zip | 33133-2764
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Country | US
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Telephone | 305-426-3779
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Fax | 305-925-8100
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Authorized Official
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Title or Position | MANAGER
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Name | ROGER K KHOURI
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Credential | MD
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Telephone | 305-426-3779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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