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General NPI Number Information
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NPI Number | 1942847496
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Entity Type | Organization
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Legal Business Name | ATLANTIC MEDICAL CENTER DORAL INC
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 10900 NW 25TH ST STE 104
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City | DORAL
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State | FL
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Zip | 33172-1922
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Country | US
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Telephone | 786-804-9521
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Fax | 305-716-9254
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Provider Business Mailing Address
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Address Line | 10900 NW 25TH ST STE 104
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City | DORAL
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State | FL
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Zip | 33172-1922
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Country | US
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Telephone | 786-804-9521
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Fax | 305-716-9254
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | ANA M DIAZ
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Credential |
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Telephone | 786-804-9521
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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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