| Organization Name: | CUTLER BAY MEDICAL & DIAGNOSTIC CENTER CORP |
| NPI Number: | 1164851515 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIRNA ESCOTO (PRESIDENT) |
| Mailing Address: | 20525 Sw 82nd Ct Cutler Bay |
| State: | FL US |
| Postal Code: | 331892632 |
| Phone Number: | 3058126875 |
| Fax Number: | 7867320637 |
| NPI Enumeration Date: | 11/06/2013 |
| NPI Last Update Date: | 11/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |