Dade County Street Response | |
4300 Nw 12th Ave Miami FL 33127-2540 | |
(610) 715-9989 | |
Not Available |
Full Name | Dade County Street Response |
---|---|
Speciality | General Practice |
Location | 4300 Nw 12th Ave, Miami, Florida |
Authorized Official Name and Position | Armen Henderson (PRESIDENT) |
Authorized Official Contact | 6107159989 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dade County Street Response 4300 Nw 12th Ave Miami FL 33127-2540 Ph: (610) 715-9989 | Dade County Street Response 4300 Nw 12th Ave Miami FL 33127-2540 Ph: (610) 715-9989 |
NPI Number | 1811680127 |
---|---|
Provider Enumeration Date | 06/01/2023 |
Last Update Date | 08/04/2023 |
Medicare PECOS PAC ID | 0749634350 |
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Medicare Enrollment ID | O20231002001085 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811680127 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Armen Henderson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1902224132 PECOS PAC ID: 4587935275 Enrollment ID: I20170728001949 |
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