Organization
SOUTHEAST PHYSICIAN ASSOCIATES 1, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENE F GOMEZ (CEO)
(305) 596-4288
Entity
Organization
Contact information
Practice address
10621 N KENDALL DR STE 211, MIAMI, FL 33176-1530
(305) 596-4288
(305) 596-6378
Mailing address
10621 N KENDALL DR STE 211, MIAMI, FL 33176-1530
(305) 596-4288
(305) 596-6378
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
05/31/2017
Last updated
07/21/2022
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