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General NPI Number Information
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NPI Number | 1881733483
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL MEDICAL SRVCS CORP
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 315 W 9TH ST FL 2
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City | HIALEAH
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State | FL
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Zip | 33010-3853
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Country | US
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Telephone | 305-888-6464
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Fax | 305-888-9696
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Provider Business Mailing Address
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Address Line | 315 W 9TH ST FL 2
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City | HIALEAH
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State | FL
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Zip | 33010-3853
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Country | US
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Telephone | 305-888-6464
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Fax | 305-888-9696
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LIZETTE SANTOS
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Credential |
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Telephone | 305-888-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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