Organization
SOUTH FLORIDA US MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS PENALVER (PRESIDENT)
(786) 493-5382
Entity
Organization
Contact information
Practice address
6850 CORAL WAY, STE 204, MIAMI, FL 33155-1758
(786) 773-2558
(305) 938-5003
Mailing address
6850 CORAL WAY, STE 204, MIAMI, FL 33155-1758
(786) 773-2558
(305) 938-5003
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC10498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IO810A
MEDICARE PTAN
FL
Enumeration date
11/18/2015
Last updated
12/22/2016
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