Organization
PROMED HEALTHCARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAGALY PASCAL TRAVIESO ARNP (CEO)
(786) 580-1859
Entity
Organization
Contact information
Practice address
11400 W FLAGLER ST STE 202, MIAMI, FL 33174-4007
(305) 548-1118
(786) 558-5697
Mailing address
11400 W FLAGLER ST STE 202, MIAMI, FL 33174-4007
(305) 548-1118
(786) 558-5697
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T612540715810
ARNP9240892
FL
Enumeration date
04/23/2019
Last updated
09/24/2024
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