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General NPI Number Information
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NPI Number | 1710338454
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Entity Type | Organization
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Legal Business Name | JAPH MEDICAL GROUP INC
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 7600 W 20TH AVE SUITE 112
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City | HIALEAH
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State | FL
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Zip | 33016-1821
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Country | US
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Telephone | 305-557-0000
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Fax | 305-557-0002
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Provider Business Mailing Address
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Address Line | 7600 W 20TH AVE SUITE 112
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City | HIALEAH
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State | FL
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Zip | 33016-1821
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Country | US
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Telephone | 305-557-0000
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Fax | 305-557-0002
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Authorized Official
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Title or Position | CHIEF OF JAPH MEDICAL GROUP INC
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Name | DR. JOSE ANTONIO PRIETO
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Credential | MD
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Telephone | 954-202-6322
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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 | ME 54503
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License Number State | FL
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