Organization
GRAN PRINCIPAL I INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL EDUARDO RODRIGUEZ MUTIS (OWNER)
(305) 974-5270
Entity
Organization
Contact information
Practice address
1557 NE 164TH ST STE 201H, NORTH MIAMI BEACH, FL 33162-4001
(305) 974-5270
Mailing address
1557 NE 164TH ST STE 201H, NORTH MIAMI BEACH, FL 33162-4001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
05/29/2025
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