| Id Professionals Of South Florida Llc | |
|
1790 W 49th St Suite 400-9 Hialeah FL 33012-2992 | |
| (305) 698-5997 | |
| (305) 698-5998 |
| Full Name | Id Professionals Of South Florida Llc |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 1790 W 49th St, Hialeah, Florida |
| Authorized Official Name and Position | Mario R. Lopez (PRESIDENT) |
| Authorized Official Contact | 9544955102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Professionals Of South Florida Llc Po Box 371082 Miami FL 33137-1082 Ph: (305) 698-5997 | Id Professionals Of South Florida Llc 1790 W 49th St Suite 400-9 Hialeah FL 33012-2992 Ph: (305) 698-5997 |
| NPI Number | 1174560619 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 01/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174560619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME75291 (Florida) | Primary |
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