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General NPI Number Information
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NPI Number | 1841369006
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Entity Type | Organization
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Legal Business Name | SOUTH DADE NEONATOLOGY
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 215 GRAND AVE
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City | CORAL GABLES
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State | FL
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Zip | 33133-4841
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Country | US
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Telephone | 305-441-7179
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Fax | 305-448-7134
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Provider Business Mailing Address
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Address Line | PO BOX 43-2620
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City | SOUTH MIAMI
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State | FL
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Zip | 33243-2620
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Country | US
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Telephone | 305-441-7179
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Fax | 305-448-7134
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Authorized Official
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Title or Position | PARTNER
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Name | ERNESTO VALDES
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Credential | MD
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Telephone | 305-441-7179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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