Provider Demographics
NPI:1043626765
Name:HEAD AND NECK TREATMENT CENTER OF MIAMI INC
Entity Type:Organization
Organization Name:HEAD AND NECK TREATMENT CENTER OF MIAMI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSERY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-552-9102
Mailing Address - Street 1:757 ARTHUR GODFREY RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3413
Mailing Address - Country:US
Mailing Address - Phone:305-672-4444
Mailing Address - Fax:305-672-8997
Practice Address - Street 1:757 ARTHUR GODFREY RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3413
Practice Address - Country:US
Practice Address - Phone:305-672-4444
Practice Address - Fax:305-672-8997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50634208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty