Organization
MEDPLAN CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL IGLESIAS (CEO)
(786) 641-5348
Entity
Organization
Contact information
Practice address
13903 NW 67TH AVE STE 250, MIAMI LAKES, FL 33014-2938
(305) 801-6952
Mailing address
8750 NW 36TH STREET, SUITE 300, DORAL, FL 33178
(786) 641-5348
(305) 615-1121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018781000
—
FL
Enumeration date
02/05/2014
Last updated
06/12/2017
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