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General NPI Number Information
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NPI Number | 1467608661
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Entity Type | Organization
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Legal Business Name | MIAMI MEDICAL INC
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 11010 SW 88TH ST STE 104-A
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City | MIAMI
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State | FL
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Zip | 33176-1216
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Country | US
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Telephone | 305-595-1122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 835266
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City | MIAMI
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State | FL
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Zip | 33283-5266
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Country | US
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Telephone | 305-595-1122
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. FLORENCE FOUCAULD
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Credential | MD
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Telephone | 305-595-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME92168
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License Number State | FL
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