Organization
IMIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BORIS NIKOLOV MD (CEO)
(305) 235-9920
Entity
Organization
Contact information
Practice address
15202 SW 80TH AVE, PALMETTO BAY, FL 33157-2202
(305) 235-9920
(305) 675-7836
Mailing address
15202 SW 80TH AVE, PALMETTO BAY, FL 33157-2202
(305) 235-9920
(305) 675-7836
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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