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General NPI Number Information
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NPI Number | 1871990341
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Entity Type | Organization
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Legal Business Name | NORTH GABLES FOOT CLINIC INC
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 4540 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33126-2307
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Country | US
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Telephone | 305-461-3448
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Fax | 786-401-6972
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Provider Business Mailing Address
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Address Line | 4540 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33126-2307
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Country | US
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Telephone | 305-461-3448
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Fax | 786-401-6972
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICARDO REYES
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Credential | DPM
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Telephone | 305-461-3448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PO2330
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License Number State | FL
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