MEDICARE: PASTEUR MEDICAL CUTLER BAY LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1275890345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASTEUR MEDICAL CUTLER BAY LLC

Provider Business Mailing Address
First Line	:	9250 W FLAGLER ST STE 600
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-3460
Country	:	US
Telephone Number	:	786-422-6821
Fax Number	:

Provider Business Practice Location Address
First Line	:	19177 S DIXIE HWY
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7714
Country	:	US
Telephone Number	:	786-249-0601
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	TARIK HAWATMEH
Credential	:
Telephone Number	:	786-249-0601

Provider Enumeration Date	:	04/13/2012
Last Update Date	:	03/04/2021

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