Organization
SOUTHEAST PHYSICIAN ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENE F GOMEZ (PRESIDENT)
(305) 458-1475
Entity
Organization
Contact information
Practice address
10621 N KENDALL DR, SUITE 211, MIAMI, FL 33176-8708
(305) 458-1475
(305) 424-2054
Mailing address
10621 N KENDALL DR, SUITE 211, MIAMI, FL 33176-8708
(305) 458-1475
(305) 424-2054
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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