Organization · NPI-2
305 Medical Centers LLC
Family Medicine · Miami, FL
NPI number1831665694
StatusActive
Last updated in NPPESJun 11, 2019
Details
- NPI
- 1831665694
- Entity type
- Organization (NPI-2)
- Legal business name
- 305 Medical Centers LLC
- Organization subpart
- No
- Enumeration date
- Oct 19, 2018
- Last updated
- Jun 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – |
Practice location
1303 Sw 107th AveMiami, FL 33174-2515
Phone 305-363-6333 · Fax 786-461-1033
Mailing address
1303 Sw 107th AveMiami, FL 33174-2515
Phone 305-363-6333 · Fax 786-461-1033
Authorized official
Roger Reyes
Administrator
7862537699
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