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General NPI Number Information
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NPI Number | 1790374056
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER INTERNATIONAL INC
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 401 E OAKLAND PARK BLVD
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City | OAKLAND PARK
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State | FL
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Zip | 33334-2149
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Country | US
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Telephone | 954-916-7241
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Fax |
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Provider Business Mailing Address
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Address Line | 401 E OAKLAND PARK BLVD
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City | OAKLAND PARK
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State | FL
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Zip | 33334-2149
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Country | US
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Telephone | 954-916-7241
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WILSON IZQUIERDO
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Credential | MD
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Telephone | 305-780-0009
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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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