Organization
BOISE MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CESAR J DIAZ HERNANDEZ (OWNER)
(786) 536-7268
Entity
Organization
Contact information
Practice address
7715 NW 48TH ST STE 350, DORAL, FL 33166-5473
(786) 536-7268
(786) 536-7608
Mailing address
7715 NW 48TH ST STE 350, DORAL, FL 33166-5473
(786) 536-7268
(786) 536-7608
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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