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General NPI Number Information
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NPI Number | 1699013821
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Entity Type | Organization
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Legal Business Name | EXCEL MEDICAL & THERAPY SERVICES
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 13055 SW 42ND ST SUITE # 108
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City | MIAMI
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State | FL
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Zip | 33175-3406
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Country | US
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Telephone | 305-220-0655
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Fax |
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Provider Business Mailing Address
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Address Line | 13055 SW 42ND ST SUITE # 108
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City | MIAMI
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State | FL
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Zip | 33175-3406
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Country | US
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Telephone | 305-220-0655
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIUSKA MESTRIL
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Credential |
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Telephone | 305-220-0655
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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 | HCC9683
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License Number State | FL
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