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General NPI Number Information
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NPI Number | 1912258211
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Entity Type | Organization
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Legal Business Name | PALMETTO MEDICAL CENTER ,INC
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 09/26/2012
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Provider Practice Location Address
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Address Line | 8150 SW 8TH ST SUITE 218
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City | MIAMI
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State | FL
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Zip | 33144-4263
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Country | US
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Telephone | 305-961-1121
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Fax | 786-693-8265
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Provider Business Mailing Address
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Address Line | 8150 SW 8TH ST SUITE 218
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City | MIAMI
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State | FL
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Zip | 33144-4263
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Country | US
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Telephone | 305-961-1121
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Fax | 786-693-8265
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIA C RIVAS
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Credential | DC
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Telephone | 305-961-1121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | P12000080531
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License Number State | FL
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