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General NPI Number Information
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NPI Number | 1467005116
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Entity Type | Organization
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Legal Business Name | MIAMI MENS HEALTH
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 135 SAN LORENZO AVE STE 540
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City | CORAL GABLES
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State | FL
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Zip | 33146-1880
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Country | US
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Telephone | 305-444-2290
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Fax |
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Provider Business Mailing Address
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Address Line | 2263 SW 37TH AVE APT 441
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City | MIAMI
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State | FL
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Zip | 33145-3262
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Country | US
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Telephone | 716-208-6781
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW BRENNAN
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Credential | DO
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Telephone | 716-208-6781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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