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General NPI Number Information
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NPI Number | 1558778399
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Entity Type | Organization
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Legal Business Name | MIAMI MEDICAL CENTER INC
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 07/14/2014
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Provider Practice Location Address
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Address Line | 1250 S MIAMI AVE STE 101
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City | MIAMI
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State | FL
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Zip | 33130-4100
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Country | US
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Telephone | 305-571-6250
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Fax | 305-571-6251
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Provider Business Mailing Address
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Address Line | 1250 S MIAMI AVE STE 101
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City | MIAMI
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State | FL
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Zip | 33130-4100
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Country | US
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Telephone | 305-571-6250
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Fax | 305-571-6251
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Authorized Official
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Title or Position | CEO
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Name | HOSSEIN JOUKAR
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Credential | M.D.
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Telephone | 305-571-6250
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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 | ME117256
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License Number State | FL
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