1669728382 NPI number — AROUND THE CLOCK MEDICAL CENTER OF NORTH MIAMI BEACH PA

Table of content: JOAN FERNANDEZ DE LA VEGA (NPI 1083468169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669728382 NPI number — AROUND THE CLOCK MEDICAL CENTER OF NORTH MIAMI BEACH PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AROUND THE CLOCK MEDICAL CENTER OF NORTH MIAMI BEACH PA
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:
1669728382
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16991 NE 20TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33162-3211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-940-9300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16991 NE 20TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH MIAMI BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33162-3211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-940-9300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2012

Additional Information

Authorized Official

Authorized Official Last Name:
GLASSMAN
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
305-940-9300

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  OS1476 , 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)





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