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General NPI Number Information
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NPI Number | 1598923450
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Entity Type | Organization
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Legal Business Name | PANAMERICAN HEALTH CENTER INC
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 4750 NW 7TH STREET SUITE 13
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City | MIAMI
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State | FL
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Zip | 33126-2253
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Country | US
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Telephone | 305-567-0060
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Fax | 305-567-0065
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Provider Business Mailing Address
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Address Line | 4750 NW 7TH STREET SUITE 13
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City | MIAMI
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State | FL
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Zip | 33126-2253
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Country | US
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Telephone | 305-567-0060
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Fax | 305-567-0065
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. CARLOS A RIVERO
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Credential | MT
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Telephone | 305-567-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8930
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI 637
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN 223
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN 316
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | CI 415
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | HCC6049
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License Number State | FL
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