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Organization
SOUTH MIAMI SPORTS MEDICINE INC.
Active
Organization
SOUTH MIAMI SPORTS MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT A MILLARES OTRL,CHT (PRESIDENT/OWNER)
(305) 666-7116
Entity
Organization
Contact information
Practice address
7000 SW 62ND AVE, SUITE 120, SOUTH MIAMI, FL 33143-4716
(305) 666-7168
Mailing address
7000 S.W. 62 AVENUE, SUITE 120, MIAMI, FL 33143
(305) 666-7168
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
OT2468
FL
Other
Enumeration date
01/10/2011
Last updated
01/10/2011
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