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General NPI Number Information
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NPI Number | 1467681445
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Entity Type | Organization
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Legal Business Name | BISCAYNE WELLNESS MEDICAL INSTITUTE, INC
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Dates
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Enumeration Date | 07/10/2009
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 13899 BISCAYNE BLVD SUITE 155
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33181-1600
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Country | US
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Telephone | 305-816-6733
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Fax | 305-808-3416
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Provider Business Mailing Address
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Address Line | 13899 BISCAYNE BLVD SUITE 155
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33181-1600
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Country | US
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Telephone | 305-816-6733
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Fax | 305-808-3416
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARIE CARMEL DOSSOUS
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Credential |
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Telephone | 954-274-0847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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