Organization
PROVISION HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CARLOS PEREZ (PRESIDENT)
(305) 889-0188
Entity
Organization
Contact information
Practice address
6916 NW 72ND AVE, MIAMI, FL 33166-3036
(305) 889-0188
Mailing address
6916 NW 72ND AVE, MIAMI, FL 33166-3036
(305) 889-0188
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HHC 8276
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HHC 8276
HEALTH CARE CLINIC
FL
Enumeration date
03/22/2010
Last updated
03/22/2010
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