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General NPI Number Information
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NPI Number | 1932671740
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Entity Type | Organization
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Legal Business Name | EXCELLENCE HEALTH CLINIC, INC
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Dates
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Enumeration Date | 12/19/2018
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 7925 NW 12TH ST STE 315
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City | DORAL
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State | FL
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Zip | 33126-1846
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Country | US
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Telephone | 786-558-9970
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Fax | 786-558-7768
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Provider Business Mailing Address
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Address Line | 7925 NW 12TH ST
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City | DORAL
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State | FL
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Zip | 33126-1827
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Country | US
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Telephone | 786-558-9970
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Fax | 786-558-7768
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Authorized Official
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Title or Position | PRESIDENT
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Name | YOISEL A PARGAS
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Credential |
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Telephone | 786-558-9970
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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 |
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License Number State |
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