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General NPI Number Information
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NPI Number | 1790044287
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Entity Type | Organization
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Legal Business Name | ACCESS MEDICAL GROUP OF OPA-LOCKA, LLC.
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 321 OPA LOCKA BLVD
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City | OPA LOCKA
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State | FL
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Zip | 33054-3526
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Country | US
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Telephone | 786-476-3333
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Fax | 786-476-3334
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Provider Business Mailing Address
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Address Line | 6100 BLUE LAGOON DR SUITE 365
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City | MIAMI
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State | FL
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Zip | 33126-2079
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Country | US
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Telephone | 786-322-7333
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Fax | 786-322-7329
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAYNY RAMIREZ
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Credential |
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Telephone | 786-322-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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