Organization
PROFESSIONAL MEDICAL SERVICES & MANAGEMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY LOPEZ (PRESIDENT/ CEO)
(786) 360-4528
Entity
Organization
Contact information
Practice address
315 W 9TH ST FL 2, HIALEAH, FL 33010-3853
(786) 360-4528
(786) 360-4529
Mailing address
315 W 9TH ST, SECOND FLOOR, HIALEAH, FL 33010-3853
(786) 360-4528
(786) 360-4529
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
FL
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000645500
—
FL
01
—
ME51845
MEDICAL LICENSE
FL
Enumeration date
10/25/2011
Last updated
01/25/2022
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