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General NPI Number Information
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NPI Number | 1669795118
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Entity Type | Organization
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Legal Business Name | ZYTRY MEDICAL SERVICES
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Dates
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Enumeration Date | 03/11/2010
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 3900 NW 79TH AVE SUITE 518
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City | DORAL
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State | FL
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Zip | 33166-6556
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Country | US
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Telephone | 305-722-8993
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Fax | 305-722-8992
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Provider Business Mailing Address
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Address Line | 3900 NW 79TH AVE SUITE 518
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City | DORAL
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State | FL
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Zip | 33166-6556
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Country | US
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Telephone | 305-722-8993
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Fax | 305-722-8992
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | JOHN L OSORIO
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Credential |
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Telephone | 305-722-8993
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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 | ME82265
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License Number State | FL
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