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General NPI Number Information
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NPI Number | 1770632457
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Entity Type | Organization
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Legal Business Name | ABC MEDICAL SERVICE, LLC.
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 1800 S.W. 1 ST. SUITE 318
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City | MIAMI
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State | FL
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Zip | 33135
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Country | US
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Telephone | 305-906-3333
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Fax | 305-914-5951
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Provider Business Mailing Address
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Address Line | 1800 S.W. 1 ST. SUITE 318
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City | MIAMI
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State | FL
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Zip | 33135
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Country | US
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Telephone | 305-906-3333
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Fax | 305-914-5951
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JOSE JOAQUIN GRAVIER
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Credential |
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Telephone | 305-906-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | ME81343
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License Number State | FL
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