Organization
DIVERSIFIED AMERICAN, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELADIO RIVES (PRESIDENT)
(786) 447-0931
Entity
Organization
Contact information
Practice address
14629 SW 104 ST, SUITE 300, MIAMI, FL 33186
(786) 447-0931
(305) 397-0358
Mailing address
14629 SW 104 ST, SUITE 300, MIAMI, FL 33186
(786) 447-0931
(305) 397-0358
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/26/2009
Last updated
01/26/2009
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