Provider Demographics
NPI:1225497886
Name:EMC SOUTH FLORIDA, LLC
Entity Type:Organization
Organization Name:EMC SOUTH FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-352-9327
Mailing Address - Street 1:6075 SW 72ND ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5000
Mailing Address - Country:US
Mailing Address - Phone:786-577-9362
Mailing Address - Fax:786-701-0606
Practice Address - Street 1:6075 SW 72ND ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5000
Practice Address - Country:US
Practice Address - Phone:786-577-9362
Practice Address - Fax:786-701-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124453202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical ExaminerGroup - Single Specialty