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General NPI Number Information
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NPI Number | 1528013976
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Entity Type | Organization
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Legal Business Name | DAVIE MEDI CENTER
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 07/31/2007
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Provider Practice Location Address
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Address Line | 3181 DAVIE BLVD
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City | DAVIE
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State | FL
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Zip | 33312-2728
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Country | US
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Telephone | 954-321-5498
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Fax |
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Provider Business Mailing Address
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Address Line | 3181 DAVIE BLVD
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City | DAVIE
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State | FL
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Zip | 33312-2728
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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 | PRESIDENT
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Name | GUZ MUNOZ
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Credential |
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Telephone | 954-321-5498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME75421
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License Number State | FL
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