Provider Demographics
NPI:1275071524
Name:KINE VIP MIAMI INC
Entity Type:Organization
Organization Name:KINE VIP MIAMI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-239-7345
Mailing Address - Street 1:7235 SW 24TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1452
Mailing Address - Country:US
Mailing Address - Phone:786-239-7345
Mailing Address - Fax:
Practice Address - Street 1:7235 SW 24TH ST STE 209
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1452
Practice Address - Country:US
Practice Address - Phone:786-239-7345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service