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NPI Code Detail

MEDICARE: THE MVMNT CLINIC

MEDICARE: THE MVMNT CLINIC
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1376146027
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE MVMNT CLINIC
Provider Business Mailing Address
First Line : 7601 SW 136TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33183-3209
Country : US
Telephone Number : 305-764-6351
Fax Number :
Provider Business Practice Location Address
First Line : 4280 SW 73RD AVE
Second Line :
City : MIAMI
State : FL
Zip : 33155-4548
Country : US
Telephone Number : 305-764-6351
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : MARIA GAITAN
Credential :
Telephone Number : 305-764-6351
Provider Enumeration Date : 11/17/2020
Last Update Date : 11/17/2020

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Directions to “THE MVMNT CLINIC ” Practice Location

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