Organization
PHYSICIANS MSO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EVALDO FRED DUPUY (PRESIDENT)
(786) 417-6668
Entity
Organization
Contact information
Practice address
2063 SW 195TH AVE, MIRAMAR, FL 33029-5920
(786) 417-6668
Mailing address
2063 SW 195TH AVE, MIRAMAR, FL 33029-5920
(786) 417-6668
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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