Provider Demographics
NPI:1487285847
Name:MIAMI MEDICAL THERAPY AND RESEARCH CENTER CORP
Entity type:Organization
Organization Name:MIAMI MEDICAL THERAPY AND RESEARCH CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-801-1106
Mailing Address - Street 1:10380 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1746
Mailing Address - Country:US
Mailing Address - Phone:786-801-1106
Mailing Address - Fax:
Practice Address - Street 1:10380 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1746
Practice Address - Country:US
Practice Address - Phone:786-801-1106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center