Organization
MERCY MEDICAL DEVELOPMENT INC
Active
Organization
MERCY MEDICAL DEVELOPMENT INC
Active
Other names
Mercy Outpatient Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY MASHBURN (CFO)
(305) 854-4400
Entity
Organization
Contact information
Practice address
3641 S MIAMI AVE, MIAMI, FL 33133-4205
(305) 860-4660
(305) 860-4682
Mailing address
PO BOX 331966, MIAMI, FL 33233-1966
(305) 860-4660
(305) 860-4682
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0203X
Therapeutic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060942100
—
FL
Enumeration date
11/18/2005
Last updated
05/29/2008
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