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General NPI Number Information
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NPI Number | 1871286716
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Entity Type | Organization
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Legal Business Name | SAGITTARIUS EDCARE, INC
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 2601 SW 37TH AVE STE 505
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City | MIAMI
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State | FL
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Zip | 33133-2750
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Country | US
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Telephone | 305-514-0861
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Fax | 305-521-8336
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Provider Business Mailing Address
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Address Line | 11 ISLAND AVE APT 810
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City | MIAMI BEACH
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State | FL
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Zip | 33139-1323
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Country | US
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Telephone | 305-491-2234
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOEL HERNANDEZ
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Credential | MD
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Telephone | 305-491-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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