NPI 1013211705

South Miami Sports Medicine INC.

Organisation Exclusive Provider Organization South Miami, FL

Practice location

Address: 7000 SW 62nd Ave Suite 120, South Miami, FL 33143-4716
Phone: (305) 666-7168
Mailing address: 7000 S.W. 62 Avenue Suite 120, Miami, FL 33143

Authorised official

Name: Robert a Millares
Title: President/Owner
Phone: (305) 666-7116

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence OT2468 (FL)

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Registry record

NPI: 1013211705
Entity type: Organization
NPI issued: 10 Jan 2011
Record last updated: 10 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.