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General NPI Number Information
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NPI Number | 1821365701
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Entity Type | Organization
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Legal Business Name | POLICINICO STA CLARA
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 2742 SW 8TH ST STE 19
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City | MIAMI
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State | FL
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Zip | 33135-4635
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Country | US
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Telephone | 305-631-9903
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Fax | 305-642-5333
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Provider Business Mailing Address
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Address Line | 2742 SW 8TH ST STE 19
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City | MIAMI
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State | FL
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Zip | 33135-4635
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Country | US
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Telephone | 305-631-9903
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Fax | 305-642-5333
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Authorized Official
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Title or Position | PRESIDENT
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Name | YAJAIRA DE JESUS SANCHEZ-FALCON
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Credential | LMT
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Telephone | 305-631-9903
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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 |
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License Number State |
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