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11300 Ne 2nd Ave Ste 104 Miami Shores FL 33161-6628 | |
| (305) 899-3750 | |
| (305) 899-3751 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 11300 Ne 2nd Ave Ste 104, Miami Shores, Florida |
| Authorized Official Name and Position | Eileen Egan-hineline (DIRECTOR STUDENT HEALTH SERVICES) |
| Authorized Official Contact | 3058993750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11300 Ne 2nd Ave Ste 104 Miami Shores FL 33161-6628 Ph: (305) 899-3750 | 11300 Ne 2nd Ave Ste 104 Miami Shores FL 33161-6628 Ph: (305) 899-3750 |
| NPI Number | 1154192862 |
|---|---|
| Provider Enumeration Date | 01/11/2024 |
| Last Update Date | 03/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154192862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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