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General NPI Number Information
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NPI Number | 1679391049
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Entity Type | Organization
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Legal Business Name | HEALTH 365, LLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 10251 SW 72ND ST STE 106
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City | MIAMI
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State | FL
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Zip | 33173-2957
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Country | US
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Telephone | 786-469-2730
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Fax | 305-428-3680
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Provider Business Mailing Address
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Address Line | 15100 SW 89TH AVE
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City | PALMETTO BAY
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State | FL
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Zip | 33176-8061
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Country | US
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Telephone | 786-303-6743
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Fax | 305-428-3680
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | AQUILES GARCIA-MENOCAL
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Credential | APRN
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Telephone | 786-303-6743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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