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General NPI Number Information
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NPI Number | 1770108110
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Entity Type | Organization
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Legal Business Name | THE NEOMEDICINE INSTITUTE LLC
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Dates
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Enumeration Date | 06/11/2020
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 2510 NW 97TH AVE STE 110
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City | DORAL
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State | FL
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Zip | 33172-1407
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Country | US
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Telephone | 786-264-2999
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Fax |
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Provider Business Mailing Address
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Address Line | 2510 NW 97TH AVE STE 110
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City | DORAL
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State | FL
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Zip | 33172-1407
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Country | US
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Telephone | 786-264-2999
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CARLA CERRA
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Credential |
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Telephone | 786-264-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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