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General NPI Number Information
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NPI Number | 1669694238
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Entity Type | Organization
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Legal Business Name | UNIVERSITY MEDICAL HEALTH CENTER PA
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1190 N W 95 STREET SUITE 302 SUITE 302
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City | MIAMI
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State | FL
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Zip | 33150
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Country | US
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Telephone | 305-835-0312
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Fax | 305-691-9224
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Provider Business Mailing Address
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Address Line | 1190 N W 95 STREET SUITE 302 SUITE 302
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City | MIAMI
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State | FL
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Zip | 33150
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Country | US
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Telephone | 305-835-0312
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Fax | 305-691-9224
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Authorized Official
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Title or Position | ADMINISTATION
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Name | M. ADAM
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Credential |
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Telephone | 305-835-0312
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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 | 4132130
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License Number State | FL
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