Organization
AXIS LE PROFESSIONAL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERENDIRA DELGADO (PRESIDENT)
(305) 877-8184
Entity
Organization
Contact information
Practice address
2604 NW 21ST TER, MIAMI, FL 33142-7113
(305) 877-8184
Mailing address
2604 NW 21ST TER, MIAMI, FL 33142-7113
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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