Organization
ACQUALINA MEDICAL GROUP AND THERAPEUTIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLAVIO CORREA (PRESIDENT)
(305) 269-8812
Entity
Organization
Contact information
Practice address
8150 SW 8TH ST, SUITE 113, MIAMI, FL 33144-4263
(305) 269-8812
(305) 269-8814
Mailing address
8150 SW 8TH ST, SUITE 113, MIAMI, FL 33144-4263
(305) 269-8812
(305) 269-8814
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC6486
AHCA LICENSE
FL
Enumeration date
01/09/2008
Last updated
09/12/2008
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