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General NPI Number Information
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NPI Number | 1548847304
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Entity Type | Organization
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Legal Business Name | MENENDEZ & FAMILY CORP
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 2172 NE 123RD ST
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2902
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Country | US
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Telephone | 786-542-5140
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Fax |
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Provider Business Mailing Address
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Address Line | 2172 NE 123RD ST
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2902
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Country | US
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Telephone | 786-542-5140
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICAL
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Name | MR. IBRAHIM MENENDEZ
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Credential | MD
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Telephone | 939-332-8801
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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 |
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License Number State |
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