1710169040 NPI number — R & L GROUP MEDICAL CENTER INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710169040 NPI number — R & L GROUP MEDICAL CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R & L GROUP MEDICAL CENTER INC
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:
1710169040
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8300 SW 8TH ST
Provider Second Line Business Mailing Address:
SUITE 307
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33144-4100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-264-6715
Provider Business Mailing Address Fax Number:
305-264-6743

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8300 SW 8TH ST
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33144-4100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-264-6715
Provider Business Practice Location Address Fax Number:
305-264-6743
Provider Enumeration Date:
11/28/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ESTEVEZ
Authorized Official First Name:
RAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
305-216-7939

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  HCC7885 , 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)