MEDICARE: OSLER MEDICAL CENTER 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	208D00000X	General Practice Physician		FL

General Provider Information

NPI Number	:	1689749855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSLER MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	246 NW 42ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5435
Country	:	US
Telephone Number	:	305-774-6725
Fax Number	:

Provider Business Practice Location Address
First Line	:	246 NW 42ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5435
Country	:	US
Telephone Number	:	305-774-6725
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RODOLFO MARIN
Credential	:
Telephone Number	:	305-774-6725

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	08/22/2020

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Directions to “OSLER MEDICAL CENTER CORP ” Practice Location

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