1306037262 NPI number — ECG ASSOCIATES OF MHI

Table of content: (NPI 1306037262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306037262 NPI number — ECG ASSOCIATES OF MHI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ECG ASSOCIATES OF MHI
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306037262
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2664 SW 87TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33165-2031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-554-0816
Provider Business Mailing Address Fax Number:
305-554-8487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4701 N MERIDIAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33140-2910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-554-0816
Provider Business Practice Location Address Fax Number:
305-554-8487
Provider Enumeration Date:
08/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KIRPALANI
Authorized Official First Name:
BHAGWAN
Authorized Official Middle Name:
U
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
305-554-0816

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  ME17140 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 375550900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com