# MIDLAND MEDICAL - MIAMI SHORES, INC.

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

## Provider details

- **NPI number:** 1548350259
- **Authorized official:** MR. MALCOM ROY (PRESIDENT)
- **Authorized official phone:** (305) 751-9677

## Contact information

- **Practice address:** 8642 NE 2ND AVE, EL PORTAL, FL 33138-3004
- **Practice address phone:** (305) 751-9677
- **Practice address fax:** (305) 899-7120
- **Mailing address:** 8642 NE 2ND AVE, EL PORTAL, FL 33138-3004
- **Mailing address phone:** (305) 751-9677
- **Mailing address fax:** (305) 899-7120

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | HCC6722 | FL | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 08/22/2020