Low T Center
Clinic/Center, Primary Care in Miramar Beach, FL. Organization (NPI-2).
NPI number1104168095
StatusActive
Last updated in NPPESMar 19, 2013
Details
- NPI
- 1104168095
- Entity type
- Organization (NPI-2)
- Legal business name
- Low T Center
- Organization subpart
- No
- Enumeration date
- Mar 19, 2013
- Last updated
- Mar 19, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | ME95148 | FL | Yes |
| 261QU0200X | Clinic/Center, Urgent Care | ME95148 | FL |
Other names
- Miramar Family Medicine (Doing Business As)
Practice location
12889 Emerald Coast Pkwy WSuite 107b
Miramar Beach, FL 32550-3243
Phone 850-830-3012
Mailing address
622 Mountain DrDestin, FL 32541-2429
Phone 850-830-3012
Authorized official
Richard Chern
Managing Member
8508303012
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