Organization
CHANGE MEDICAL INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN JULIO HERNANDEZ POMBO (ADMINISTRATOR)
(786) 970-4674
Entity
Organization
Contact information
Practice address
1830 NW 7TH ST, SUITE 230, MIAMI, FL 33125-3569
(786) 970-4674
Mailing address
1830 NW 7TH ST, SUITE 230, MIAMI, FL 33125-3569
(786) 970-4674
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME84722
FL
Other
Enumeration date
12/01/2008
Last updated
12/01/2008
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