Organization Name: | FLAGLER MEDICAL & DIAGNOSTIC CENTER INC |
NPI Number: | 1346519089 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSE VALIENTE (OWNER) |
Mailing Address: | 4699 W Flagler St Coral Gables |
State: | FL US |
Postal Code: | 331341512 |
Phone Number: | 3054610799 |
Fax Number: | 3054610775 |
NPI Enumeration Date: | 12/27/2011 |
NPI Last Update Date: | 12/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME23012 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |