MEDICARE: FIRST MEDICAL SERVICES OF MIAMI

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	207Q00000X	Family Medicine Physician	HCC4469	FL

General Provider Information

NPI Number	:	1699721423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST MEDICAL SERVICES OF MIAMI

Provider Business Mailing Address
First Line	:	2500 SW 107TH AVE
Second Line	:	SUITE 47/47
City	:	MIAMI
State	:	FL
Zip	:	33165-2470
Country	:	US
Telephone Number	:	305-228-9601
Fax Number	:	305-228-9602

Provider Business Practice Location Address
First Line	:	2500 SW 107TH AVE
Second Line	:	SUITE 47/47
City	:	MIAMI
State	:	FL
Zip	:	33165-2470
Country	:	US
Telephone Number	:	305-228-9601
Fax Number	:	305-228-9602

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRISMEL MARQUEZ
Credential	:
Telephone Number	:	305-228-9601

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	08/22/2020

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Directions to “FIRST MEDICAL SERVICES OF MIAMI ” Practice Location

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