Organization
PRIME SOUTH FLORIDA P.A INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISMELYS TRUJILLO GAMA LMT (PRESIDENT)
(305) 378-9968
Entity
Organization
Contact information
Practice address
11285 SW 211TH ST STE 205, MIAMI, FL 33189-2211
(305) 378-9968
Mailing address
11285 SW 211TH ST STE 205, MIAMI, FL 33189-2211
(305) 378-9968
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
PA9100183
FL
Other
Enumeration date
10/29/2013
Last updated
11/04/2013
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