Provider Demographics
NPI:1316188089
Name:PRIMARY CARE AND DIABETES GROUP OF KENDALL
Entity Type:Organization
Organization Name:PRIMARY CARE AND DIABETES GROUP OF KENDALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRETON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-670-4424
Mailing Address - Street 1:8200 SW 117TH AVE
Mailing Address - Street 2:SUITE #210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4824
Mailing Address - Country:US
Mailing Address - Phone:305-670-4424
Mailing Address - Fax:
Practice Address - Street 1:8200 SW 117TH AVE
Practice Address - Street 2:SUITE #210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4824
Practice Address - Country:US
Practice Address - Phone:305-670-4424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty