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MIAMI, FL
NPI1558807933
Entity TypeOrganization
Authorized ContactEDWIN SMITH
Owner
786-916-6764
Organization Subpart ?No
Primary Taxonomy305R00000X Preferred Provider Organization
Enumeration Date2017-01-10
Last Update Date2022-07-21
Business Address
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16451 NE 6TH AVE UNIT # 51
MIAMI, FL 33162-3675
Phone number: 786-916-6764
Mailing Address
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16451 NE 6TH AVE UNIT # 51
MIAMI, FL 33162
Phone number: 786-916-6764
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