Organization
MEDPLAN CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANUEL IGLESIAS (CHIEF EXECUTIVE OFFICER)
(786) 641-5348
Entity
Organization
Contact information
Practice address
150 NW 168TH ST STE 301, NORTH MIAMI BEACH, FL 33169-6051
(305) 654-5440
Mailing address
8750 NW 36TH ST STE 300, DORAL, FL 33178-2499
(786) 641-5348
(305) 615-1121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018781000
—
FL
Enumeration date
04/06/2016
Last updated
07/21/2022
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