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Organization
MEDSTATION MIAMI PRIMARY CARE LLC
Active
Organization
MEDSTATION MIAMI PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THIERRY O. JACQUEMIN DO (MANAGEER MEMBER)
(305) 667-1511
Entity
Organization
Contact information
Practice address
6701 SUNSET DR, SUITE # 112, SOUTH MIAMI, FL 33143-4529
(305) 667-1511
(305) 503-8955
Mailing address
6701 SUNSET DR, SUITE # 112, SOUTH MIAMI, FL 33143-4529
(305) 667-1511
(305) 503-8955
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS9856
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001536700
—
FL
01
—
1750407086
NPI INDIVIDUAL
FL
Enumeration date
08/29/2016
Last updated
08/29/2016
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