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General NPI Number Information
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NPI Number | 1952584377
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Entity Type | Organization
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Legal Business Name | DOUGLAS GARDENS AT CORAL WAY INC
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 1757 CORAL WAY
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City | CORAL GABLES
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State | FL
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Zip | 33145-2728
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Country | US
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Telephone | 305-854-2555
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Fax | 305-854-4411
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Provider Business Mailing Address
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Address Line | 5200 NE 2ND AVE
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City | MIAMI
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State | FL
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Zip | 33137-2706
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Country | US
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Telephone | 305-762-1393
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Fax | 305-762-1488
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. MARK T KNIGHT
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Credential |
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Telephone | 305-762-1393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | 127
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License Number State | FL
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