Organization
BELTRAN MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDALMIS SANTANA-PORBEN MD (PRESIDENT)
(305) 551-2165
Entity
Organization
Contact information
Practice address
14223 SW 42 ST, MIAMI DADE, FL 33175-6408
(305) 551-2165
(305) 551-2167
Mailing address
14223 SW 42 ST, MIAMI DADE, FL 33175-6408
(305) 551-2165
(305) 551-2167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME88244
FL
208000000X
Pediatrics Physician
ME91105
FL
208D00000X
General Practice Physician
ME91105
FL
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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