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General NPI Number Information
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NPI Number | 1518355718
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Entity Type | Organization
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Legal Business Name | PWS MEDICAL PA
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 08/04/2015
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Provider Practice Location Address
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Address Line | 8200 SW 117TH AVE #300
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City | MIAMI
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State | FL
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Zip | 33183-3856
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Country | US
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Telephone | 305-901-2133
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Fax | 305-901-2117
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Provider Business Mailing Address
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Address Line | PO BOX 560275
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City | MIAMI
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State | FL
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Zip | 33256-0275
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Country | US
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Telephone | 305-901-2133
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | GUILLERMO SAMPER
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Credential | M.D.
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Telephone | 305-901-2133
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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 | ME97045
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License Number State | FL
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