Provider Demographics
NPI:1346409778
Name:MIAMI PRIMARY CARE LLC
Entity Type:Organization
Organization Name:MIAMI PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-552-5350
Mailing Address - Street 1:9951 BIRD RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3989
Mailing Address - Country:US
Mailing Address - Phone:305-552-5350
Mailing Address - Fax:305-220-5602
Practice Address - Street 1:9951 BIRD RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3989
Practice Address - Country:US
Practice Address - Phone:305-552-5350
Practice Address - Fax:305-220-5602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty