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General NPI Number Information
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NPI Number | 1942671862
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Entity Type | Organization
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Legal Business Name | WHITE DIAMOND CENTER CORP.
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 2260 SW 8TH ST STE 300
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City | MIAMI
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State | FL
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Zip | 33135-4938
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Country | US
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Telephone | 305-897-0721
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Fax | 305-914-4327
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Provider Business Mailing Address
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Address Line | 2260 SW 8TH ST STE 300
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City | MIAMI
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State | FL
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Zip | 33135-4938
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Country | US
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Telephone | 305-897-0721
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Fax | 305-914-4327
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Authorized Official
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Title or Position | PRESIDENT
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Name | HUGO MARTIN ESPINOSA
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Credential | M.D.
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Telephone | 305-897-0721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | ME116074
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License Number State | FL
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