Organization
BACALLAO HEALTH SERVICES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE J BACALLAO MD (PRESIDENT)
(305) 541-8849
Entity
Organization
Contact information
Practice address
2471 NW 7TH ST, MIAMI, FL 33125-3150
(305) 541-8849
(305) 541-4658
Mailing address
2471 NW 7TH ST, MIAMI, FL 33125-3150
(305) 541-8849
(305) 541-4658
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME92076
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268789500
—
FL
Enumeration date
08/26/2008
Last updated
08/26/2008
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