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General NPI Number Information
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NPI Number | 1689803157
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Entity Type | Organization
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Legal Business Name | EDMI Y CORTES TORRES MD PA
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 1695 NW 9TH AVE (D-29) ROOM #3100
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City | MIAMI
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State | FL
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Zip | 33136-1409
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Country | US
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Telephone | 786-317-2134
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 278533
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City | MIRAMAR
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State | FL
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Zip | 33027-8533
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Country | US
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Telephone | 786-317-2134
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDMI Y CORTES TORRES
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Credential | MD
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Telephone | 786-317-2134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME97126
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License Number State | FL
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