| Mivip Medical Group Inc | |
|
351 Nw 42nd Ave Suite 408 Miami FL 33126-5683 | |
| (561) 392-3341 | |
| Not Available |
| Full Name | Mivip Medical Group Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 351 Nw 42nd Ave, Miami, Florida |
| Authorized Official Name and Position | Isaac Verbukh (OWBER) |
| Authorized Official Contact | 5613923341 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mivip Medical Group Inc 398 Camino Gardens Blvd Suite 102 Boca Raton FL 33432-5827 Ph: (561) 392-3341 | Mivip Medical Group Inc 351 Nw 42nd Ave Suite 408 Miami FL 33126-5683 Ph: (561) 392-3341 |
| NPI Number | 1477996544 |
|---|---|
| Provider Enumeration Date | 04/09/2013 |
| Last Update Date | 01/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477996544 | NPI | - | NPPES |
| 004L9 | Other | FL | BCBSFL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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