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Organization
MANENT MEDICAL CENTER INC
Active
Organization
MANENT MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME ALVERO FERNANDEZ MA (PRESIDENT)
(305) 504-9783
Entity
Organization
Contact information
Practice address
5190 NW 167TH ST STE 310, MIAMI LAKES, FL 33014-6338
(305) 504-9783
(305) 470-7445
Mailing address
5190 NW 167TH ST STE 310, MIAMI LAKES, FL 33014-6338
(305) 504-9783
(305) 470-7445
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
—
NULL
207QB0002X
Obesity Medicine (Family Medicine) Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
NULL
Other
Enumeration date
04/15/2015
Last updated
06/08/2015
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