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General NPI Number Information
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NPI Number | 1861849861
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Entity Type | Organization
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Legal Business Name | ALFREDO HEVIA MD PA
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 10390 SW 97TH ST
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City | MIAMI
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State | FL
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Zip | 33176-2715
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Country | US
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Telephone | 718-200-4016
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Fax |
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Provider Business Mailing Address
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Address Line | 10390 SW 97TH ST
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City | MIAMI
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State | FL
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Zip | 33176-2715
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING AGENT
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Name | JUAN LOPEZ
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Credential |
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Telephone | 305-251-3991
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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 | ME89871
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License Number State | FL
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