NPI 1134544901

International Medical Center INC

Organisation Exclusive Provider Organization Miami, FL

Practice location

Address: 10 NW 42nd Ave Suite # 600, Miami, FL 33126-5473
Phone: (305) 644-0977
Fax: (305) 644-0114

Authorised official

Name: Larry de Jesus
Title: Owner
Phone: (786) 518-1911

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Florida →

Registry record

NPI: 1134544901
Entity type: Organization
NPI issued: 3 Mar 2014
Record last updated: 3 Mar 2014

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.