=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427007038
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDICAL AID INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4851 NW 79TH AVE SUITE 10
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33166-5453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-594-2630
-----------------------------------------------------
Fax | 305-594-2631
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4851 NW 79TH AVE SUITE 10
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33166-5453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MARTA VALDES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-594-2630
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | ME37781
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------