Organization
MIAMI STROKE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER COLEN (CREDENTIALING MANAGER)
(305) 235-9550
Entity
Organization
Contact information
Practice address
11750 SW 40TH ST, MIAMI, FL 33175-3530
(305) 235-9550
Mailing address
13550 SW 120TH ST STE 502, MIAMI, FL 33186-7505
(305) 235-9550
(305) 235-0556
Taxonomy
Speciality
Code
Description
License number
State
2084V0102X
Vascular Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23588R
P-TAN
FL
05
—
374074900
—
FL
Enumeration date
02/01/2017
Last updated
03/17/2018
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