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General NPI Number Information
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NPI Number | 1619302643
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Entity Type | Organization
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Legal Business Name | KHARI BRIDGES, MD LLC
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 8950 SW 74TH CT SUITE 1413
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City | MIAMI
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State | FL
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Zip | 33156-3171
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Country | US
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Telephone | 305-670-0146
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Fax | 305-670-8943
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Provider Business Mailing Address
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Address Line | 8950 SW 74TH CT SUITE 1413
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City | MIAMI
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State | FL
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Zip | 33156-3171
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Country | US
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Telephone | 305-670-0146
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Fax | 305-670-8943
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANA GUZMAN
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Credential |
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Telephone | 305-670-0146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME99204
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License Number State | FL
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