MEDICARE: ASSOCIATES MEDICAL CENTER INC

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1326074766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATES MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	3240 NW 7TH STREET
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125
Country	:	US
Telephone Number	:	305-649-0492
Fax Number	:

Provider Business Practice Location Address
First Line	:	3240 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-4102
Country	:	US
Telephone Number	:	305-649-0492
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CARLOS MILLAN
Credential	:
Telephone Number	:	305-649-0492

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	07/26/2010

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