Organization
MEDPLAN CLINICS , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL IGLESIAS (CHIEF EXECUTIVE OFFICER)
(786) 641-5348
Entity
Organization
Contact information
Practice address
150 NW 168TH ST # 301, NORTH MIAMI BEACH, FL 33169-6045
(305) 962-1789
Mailing address
8750 NW 36TH STREET, SUITE 300, DORAL, FL 33178
(786) 641-5348
(305) 615-1121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08781000
—
FL
Enumeration date
03/15/2016
Last updated
06/12/2017
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