MEDICARE: TRAUMATIC MEDICAL SERVICES 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	261Q00000X	Clinic/Center	HCC6073	FL

General Provider Information

NPI Number	:	1588642011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAUMATIC MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	5518 W FLAGLER ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1078
Country	:	US
Telephone Number	:	305-261-3344
Fax Number	:	305-261-5960

Provider Business Practice Location Address
First Line	:	5518 W FLAGLER ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1078
Country	:	US
Telephone Number	:	305-261-3344
Fax Number	:	305-261-5960

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GERARDO MIRANDA
Credential	:
Telephone Number	:	305-299-5261

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	01/29/2008

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