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General NPI Number Information
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NPI Number | 1730569021
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Entity Type | Organization
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Legal Business Name | CACERES MEDICAL INC
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 7250 W 24TH AVE STE 2
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City | HIALEAH
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State | FL
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Zip | 33016-6575
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Country | US
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Telephone | 305-510-8901
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Fax | 305-552-7648
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Provider Business Mailing Address
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Address Line | 7250 W 24TH AVE STE 2
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City | HIALEAH
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State | FL
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Zip | 33016-6575
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Country | US
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Telephone | 305-510-8901
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Fax | 305-552-7648
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Authorized Official
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Title or Position | OWNER
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Name | LIRON BELTZER
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Credential | M. D.
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Telephone | 305-510-8901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | ME105585
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License Number State | FL
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