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General NPI Number Information
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NPI Number | 1710908645
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Entity Type | Organization
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Legal Business Name | E & E MEDICAL CENTER DIAGNOSTIC INC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 5190 NW 167TH ST SUITE 114
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City | MIAMI GARDENS
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State | FL
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Zip | 33014-6328
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Country | US
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Telephone | 305-627-6644
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Fax |
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Provider Business Mailing Address
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Address Line | 5190 NW 167TH ST SUITE 114
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City | MIAMI GARDENS
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State | FL
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Zip | 33014-6328
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Country | US
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Telephone | 305-627-6644
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GERALD M HOFFMAN
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Credential | DO
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Telephone | 305-627-6644
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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 |
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License Number State |
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