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General NPI Number Information
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NPI Number | 1972807410
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Entity Type | Organization
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Legal Business Name | DR CUBANO MEDICAL CENTER
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Dates
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Enumeration Date | 12/25/2010
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Last Update Date | 12/25/2010
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Provider Practice Location Address
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Address Line | 600 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4402
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Country | US
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Telephone | 305-888-4440
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Fax | 305-888-4483
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Provider Business Mailing Address
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Address Line | 600 E 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4402
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Country | US
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Telephone | 305-888-4440
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Fax | 305-888-4483
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Authorized Official
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Title or Position | OWNER
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Name | JOSE JAVIER GONZALEZ
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Credential |
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Telephone | 305-888-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MM26214
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License Number State | FL
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