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General NPI Number Information
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NPI Number | 1619904323
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Entity Type | Organization
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Legal Business Name | DOC'S MEDICAL CLINIC INC
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 515 SW 17TH AVE
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City | MIAMI
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State | FL
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Zip | 33135-3878
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Country | US
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Telephone | 305-643-3847
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Fax |
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Provider Business Mailing Address
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Address Line | 515 SW 17TH AVE
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City | MIAMI
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State | FL
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Zip | 33135-3878
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Country | US
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Telephone | 305-643-3847
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | ROBERTO TAPANES
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Credential |
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Telephone | 305-643-3847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | CH8828
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License Number State | FL
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