MEDICARE: UNIVERSITY OF MIAMI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	1704612	FL

General Provider Information

NPI Number	:	1053370221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF MIAMI

Provider Business Mailing Address
First Line	:	1400 NW 10TH AVE
Second Line	:	10TH FLOOR
City	:	MIAMI
State	:	FL
Zip	:	33136-1000
Country	:	US
Telephone Number	:	305-243-5832
Fax Number	:	305-243-2152

Provider Business Practice Location Address
First Line	:	1400 NW 10TH AVE
Second Line	:	10TH FLOOR
City	:	MIAMI
State	:	FL
Zip	:	33136-1000
Country	:	US
Telephone Number	:	305-243-5832
Fax Number	:	305-243-2152

Authorized Official
Title or Position	:	OB/GYN RESEARCH DIRECTOR
Name	:	MRS. JONELL POTTER
Credential	:	ARNP PHD
Telephone Number	:	305-243-2173

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	08/22/2020

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Directions to “UNIVERSITY OF MIAMI ” Practice Location

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