| Manuel J Bacallao M.d., L.l.c. | |
|
8525 Sw 92nd St Suite B-4 Miami FL 33156-7365 | |
| (305) 279-7446 | |
| (305) 598-8753 |
| Full Name | Manuel J Bacallao M.d., L.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 8525 Sw 92nd St, Miami, Florida |
| Authorized Official Name and Position | Manuel J Bacallao (PHYSICIAN) |
| Authorized Official Contact | 3052797446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manuel J Bacallao M.d., L.l.c. 8525 Sw 92nd St Suite B-4 Miami FL 33156-7365 Ph: (305) 279-7446 | Manuel J Bacallao M.d., L.l.c. 8525 Sw 92nd St Suite B-4 Miami FL 33156-7365 Ph: (305) 279-7446 |
| NPI Number | 1275882904 |
|---|---|
| Provider Enumeration Date | 09/10/2012 |
| Last Update Date | 09/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275882904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0038837 (Florida) | Primary |
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