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General NPI Number Information
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NPI Number | 1659023927
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Entity Type | Organization
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Legal Business Name | MCI CLINICAL RESEARCH AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 11410 SW 88TH ST STE 203
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City | MIAMI
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State | FL
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Zip | 33176-1031
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Country | US
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Telephone | 786-679-1425
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Fax |
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Provider Business Mailing Address
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Address Line | 11410 SW 88TH ST STE 203
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City | MIAMI
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State | FL
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Zip | 33176-1031
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CRISITIAN GERMAN MACAGNI
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Credential |
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Telephone | 786-682-3232
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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 |
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License Number State |
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