Provider Demographics
NPI:1306004916
Name:SAMOHO HEALTHCARE SOUTH BEACH LLC
Entity Type:Organization
Organization Name:SAMOHO HEALTHCARE SOUTH BEACH LLC
Other - Org Name:MEDIGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-666-2427
Mailing Address - Street 1:5901 SW 74TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5165
Mailing Address - Country:US
Mailing Address - Phone:305-665-4614
Mailing Address - Fax:305-667-0239
Practice Address - Street 1:1355 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-3811
Practice Address - Country:US
Practice Address - Phone:305-665-4614
Practice Address - Fax:305-667-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty