Organization
GROUP MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAUSTO P ASTILLO (PRESIDENT)
(305) 603-9636
Entity
Organization
Contact information
Practice address
540 NW 165TH ST STE 302, MIAMI, FL 33169-6304
(305) 603-9636
Mailing address
540 NW 165TH ST STE 302, MIAMI, FL 33169-6304
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/27/2013
Last updated
04/27/2013
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