Organization
MED SPA & REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL R RONCHETTA M.D (PRESIDENT)
(305) 443-1172
Entity
Organization
Contact information
Practice address
4800 W FLAGLER ST, SUITE 103, CORAL GABLES, FL 33134-1446
(305) 443-1172
(305) 442-2816
Mailing address
4800 W FLAGLER ST, SUITE 103, CORAL GABLES, FL 33134-1446
(305) 443-1172
(305) 442-2816
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME33465
MEDICAL LICENSE
FL
Enumeration date
07/24/2013
Last updated
07/24/2013
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