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General NPI Number Information
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NPI Number | 1972923647
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Entity Type | Organization
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Legal Business Name | HEALTHNET MEDICAL, LLC
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 8660 W FLAGLER ST SUITE 111
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City | MIAMI
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State | FL
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Zip | 33144-2031
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Country | US
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Telephone | 305-753-9075
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Fax | 305-901-1716
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Provider Business Mailing Address
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Address Line | 8660 W FLAGLER ST SUITE 111
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City | MIAMI
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State | FL
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Zip | 33144-2031
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Country | US
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Telephone | 305-753-9075
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Fax | 305-901-1716
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Authorized Official
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Title or Position | CREDENTIALING
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Name | MR. MIKE RICHARD MOYA
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Credential |
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Telephone | 305-667-8007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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