Provider Demographics
NPI:1184862765
Name:UNIVERSITY OF MIAMI
Entity Type:Organization
Organization Name:UNIVERSITY OF MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PHD
Authorized Official - Phone:305-243-9462
Mailing Address - Street 1:1600 NW 10TH AVE
Mailing Address - Street 2:SUITE #8150
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1015
Mailing Address - Country:US
Mailing Address - Phone:305-243-3939
Mailing Address - Fax:305-243-4046
Practice Address - Street 1:1600 NW 10TH AVE
Practice Address - Street 2:SUITE #8150
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1015
Practice Address - Country:US
Practice Address - Phone:305-243-3939
Practice Address - Fax:305-243-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800001596291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D0680331OtherCLIA #