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NPI 1487074993

NPI 1487074993 : MEDICAL IN MIAMI.INC : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1487074993
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    Entity Type          |    Organization 
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    Legal Business Name  |    MEDICAL IN MIAMI.INC 
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Dates
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    Enumeration Date     |    04/23/2014
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    Last Update Date     |    04/23/2014
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Provider Practice Location Address
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    Address Line         |    13197 SW 11TH LANE CIR 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33184-2058
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    Country              |    US
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    Telephone            |    786-356-5595
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    13197 SW 11TH LANE CIR 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33184-2058
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     STEVEN  VENTURA 
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    Credential           |    
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    Telephone            |    786-356-5595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    
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    License Number State |    
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