Organization
MIAMI PEDIATRIC GASTROENTEROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAGHAD KOUTOUBY MD (MEMBER)
(305) 512-3345
Entity
Organization
Contact information
Practice address
8525 SW 92ND ST, SUITE C-11A, MIAMI, FL 33156-7365
(786) 270-3900
Mailing address
8525 SW 92ND ST, SUITE C-11A, MIAMI, FL 33156-7365
(305) 512-3345
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/05/2016
Last updated
05/16/2016
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