# SOUTH MIAMI SPORTS MEDICINE INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013211705
- **Authorized official:** MR. ROBERT A MILLARES OTRL,CHT (PRESIDENT/OWNER)
- **Authorized official phone:** (305) 666-7116

## Contact information

- **Practice address:** 7000 SW 62ND AVE, SUITE 120, SOUTH MIAMI, FL 33143-4716
- **Practice address phone:** (305) 666-7168
- **Mailing address:** 7000 S.W. 62 AVENUE, SUITE 120, MIAMI, FL 33143
- **Mailing address phone:** (305) 666-7168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | OT2468 | FL | Yes |

## Other

- **Enumeration date:** 01/10/2011
- **Last updated:** 01/10/2011