Provider Demographics
NPI:1184184673
Name:MIAVIP MEDICAL STAFFING,LLC
Entity Type:Organization
Organization Name:MIAVIP MEDICAL STAFFING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-800-7350
Mailing Address - Street 1:5944 CORAL RIDGE DR # 170
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3300
Mailing Address - Country:US
Mailing Address - Phone:954-800-7350
Mailing Address - Fax:954-827-0852
Practice Address - Street 1:7600 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3601
Practice Address - Country:US
Practice Address - Phone:954-800-7350
Practice Address - Fax:954-827-0852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty