| Midland Medical - Miami Shores, Inc. | |
|
8642 Ne 2nd Ave El Portal FL 33138-3004 | |
| (305) 751-9677 | |
| (305) 899-7120 |
| Full Name | Midland Medical - Miami Shores, Inc. |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 8642 Ne 2nd Ave, El Portal, Florida |
| Authorized Official Name and Position | Malcom Roy (PRESIDENT) |
| Authorized Official Contact | 3057519677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midland Medical - Miami Shores, Inc. 8642 Ne 2nd Ave El Portal FL 33138-3004 Ph: (305) 751-9677 | Midland Medical - Miami Shores, Inc. 8642 Ne 2nd Ave El Portal FL 33138-3004 Ph: (305) 751-9677 |
| NPI Number | 1548350259 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548350259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | HCC6722 (Florida) | Primary |
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