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General NPI Number Information
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NPI Number | 1609033455
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF VETERANS AFFAIRS @ MIAMI
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 1201 NW 16TH ST
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-575-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 665 NE 195TH ST APT 227
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-3339
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Country | US
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Telephone | 305-999-0341
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARY D BERROCAL
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Credential | MBA
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Telephone | 305-575-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | RN3285222
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License Number State | FL
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