Organization
MED PLAN CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL IGLESIAS (CEO)
(786) 641-5348
Entity
Organization
Contact information
Practice address
7200 NW 7TH STREET, MIAMI, FL 33126
(305) 266-2929
(305) 907-6099
Mailing address
3155 NW 77TH AVENUE, MIAMI, FL 33122
(305) 266-2929
(305) 907-6099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
O18781000
—
FL
Enumeration date
03/22/2013
Last updated
06/12/2017
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