| Organization Name: | PROFESSIONAL MEDICAL HEALTH SERVICES LLC |
| NPI Number: | 1184893034 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUIS CAMPILLO (PRESIDENT) |
| Mailing Address: | 5190 Nw 167th St Ste 104 Miami Lakes |
| State: | FL US |
| Postal Code: | 330146337 |
| Phone Number: | 7869556598 |
| Fax Number: | 7869556857 |
| NPI Enumeration Date: | 02/25/2008 |
| NPI Last Update Date: | 03/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME64856 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |