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General NPI Number Information
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NPI Number | 1750632972
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Entity Type | Organization
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Legal Business Name | JWH MIAMI LAKES II, LLC
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Dates
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Enumeration Date | 09/27/2012
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 16320 NW 59 AVE
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City | MIAMI LAKES
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State | FL
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Zip | 33014
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Country | US
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Telephone | 305-558-1444
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Fax | 305-558-9578
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Provider Business Mailing Address
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Address Line | 9100 S DADELAND BLVD STE 1400
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City | MIAMI
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State | FL
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Zip | 33156-7816
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Country | US
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Telephone | 305-614-7740
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Fax | 305-558-9578
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Authorized Official
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Title or Position | DIRECTOR OF PROVIDER RELATIONS
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Name | MR. DAIMILSIS SALGADO
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Credential |
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Telephone | 305-614-7740
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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 | OS004878
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License Number State | FL
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