Organization
DURBAN MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIO RODRIGUEZ (ADM)
(786) 641-1312
Entity
Organization
Contact information
Practice address
1212 NW 79TH ST, MIAMI, FL 33147-8209
(786) 703-9896
Mailing address
1212 NW 79TH ST, MIAMI, FL 33147-8209
(786) 703-9896
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
09/22/2020
Last updated
12/27/2020
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