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General NPI Number Information
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NPI Number | 1669896734
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Entity Type | Organization
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Legal Business Name | MEDICAL SERVICES OF FLORIDA, INC
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 344 W 65TH ST SUITE #204
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City | HIALEAH
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State | FL
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Zip | 33012-6719
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Country | US
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Telephone | 305-320-8236
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Fax | 305-603-8401
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Provider Business Mailing Address
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Address Line | 344 W 65TH ST SUITE #204
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City | HIALEAH
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State | FL
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Zip | 33012-6719
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Country | US
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Telephone | 305-320-8236
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Fax | 305-603-8401
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOURDES MEDINA
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Credential |
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Telephone | 305-320-8236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MA59645
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License Number State | FL
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