MEDICARE: M & Y MEDICAL OFFICE CORP

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	261QH0100X	Health Service Clinic/Center	MA 66715	FL

General Provider Information

NPI Number	:	1326457086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M & Y MEDICAL OFFICE CORP

Provider Business Mailing Address
First Line	:	1518 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3159
Country	:	US
Telephone Number	:	786-384-0020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1518 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3159
Country	:	US
Telephone Number	:	786-384-0020
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GEORGINA ARES
Credential	:
Telephone Number	:	786-384-0020

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	08/07/2014

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Directions to “M & Y MEDICAL OFFICE CORP ” Practice Location

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