Organization
RED DIAMOND MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERTO BURGOS-TIBURCIO M.D. (OWNER/PRESIDENT)
(305) 261-0057
Entity
Organization
Contact information
Practice address
85 GRAND CANAL DR STE 107, MIAMI, FL 33144-2566
(305) 261-0057
(305) 261-0058
Mailing address
85 GRAND CANAL DR SUITE 107, MIAMI, FL 33144
(305) 261-0057
(305) 261-0058
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
ME104754
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001381800
—
FL
Enumeration date
10/18/2016
Last updated
10/18/2016
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