Provider Demographics
NPI:1003478595
Name:ALLEGIANT MEDICAL AND RESEARCH CENTER
Entity Type:Organization
Organization Name:ALLEGIANT MEDICAL AND RESEARCH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-343-2122
Mailing Address - Street 1:10240 SW 56TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7066
Mailing Address - Country:US
Mailing Address - Phone:786-332-4577
Mailing Address - Fax:786-332-4367
Practice Address - Street 1:10240 SW 56TH ST STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7066
Practice Address - Country:US
Practice Address - Phone:786-332-4577
Practice Address - Fax:786-332-4367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty