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General NPI Number Information
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NPI Number | 1669654471
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Entity Type | Organization
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Legal Business Name | MAGNIFICO PC
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 3990 W FLAGLER ST SUITE 500
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City | CORAL GABLES
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State | FL
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Zip | 33134-1644
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Country | US
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Telephone | 786-547-2725
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Fax |
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Provider Business Mailing Address
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Address Line | 404 SW 19TH RD
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City | MIAMI
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State | FL
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Zip | 33129-1314
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Country | US
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Telephone | 786-547-2725
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. VLADIMIRO GIUA
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Credential | M.D.
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Telephone | 786-547-2725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME88429
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License Number State | FL
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