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General NPI Number Information
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NPI Number | 1659505881
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Entity Type | Organization
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Legal Business Name | CUTLER RIDGE MEDICAL CENTER LLC
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Dates
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Enumeration Date | 05/01/2009
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 10700 CARIBBEAN BLVD SUITE 315
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City | CUTLER BAY
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State | FL
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Zip | 33189-1232
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Country | US
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Telephone | 305-238-2961
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Fax | 305-238-2618
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Provider Business Mailing Address
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Address Line | 10700 CARIBBEAN BLVD SUITE 315
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City | CUTLER BAY
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State | FL
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Zip | 33189-1232
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Country | US
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Telephone | 305-238-2961
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Fax | 305-238-2618
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Authorized Official
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Title or Position | MGMR
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Name | MR. WAYNE M WILLIAMS
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Credential | M.D.
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Telephone | 305-238-2961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME39949
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License Number State | FL
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