Organization
MIBASO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHUVA GAMLIEL AP (CEO)
(786) 537-0771
Entity
Organization
Contact information
Practice address
1045 KANE CONCOURSE, 214, BAY HARBOR ISLANDS, FL 33154-2119
(786) 537-0771
Mailing address
1045 KANE CONCOURSE, 214, BAY HARBOR ISLANDS, FL 33154-2119
(786) 537-0771
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AP2313
FL
Other
Enumeration date
01/18/2011
Last updated
01/18/2011
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