Pmc Jackson South, LLC
Clinic/Center in Miami, FL. Organization (NPI-2).
NPI number1043469232
StatusActive
Last updated in NPPESSep 12, 2008
Details
- NPI
- 1043469232
- Entity type
- Organization (NPI-2)
- Legal business name
- Pmc Jackson South, LLC
- Organization subpart
- No
- Enumeration date
- Sep 12, 2008
- Last updated
- Sep 12, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | FL | Yes |
Practice location
9380 Sw 150th St Ste 100Miami, FL 33176-7979
Phone 305-253-2665
Mailing address
12550 Biscayne Blvd Ste 500North Miami, FL 33181-2544
Phone 305-868-7180
Authorized official
Spencer Angel
Mng Mbr
3058687180
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