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Organization
305 MEDICAL CENTERS LLC
Active
Organization
305 MEDICAL CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER REYES (ADMINISTRATOR)
(786) 253-7699
Entity
Organization
Contact information
Practice address
1303 SW 107TH AVE, MIAMI, FL 33174-2515
(305) 363-6333
(786) 461-1033
Mailing address
1303 SW 107TH AVE, MIAMI, FL 33174-2515
(305) 363-6333
(786) 461-1033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274535600
—
FL
Enumeration date
10/19/2018
Last updated
06/11/2019
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