Provider Demographics
NPI:1407905045
Name:BRIAN MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:BRIAN MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:BORROTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-264-1916
Mailing Address - Street 1:7175 SW 8TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4676
Mailing Address - Country:US
Mailing Address - Phone:305-264-1916
Mailing Address - Fax:305-264-1917
Practice Address - Street 1:7175 SW 8TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4676
Practice Address - Country:US
Practice Address - Phone:305-264-1916
Practice Address - Fax:305-264-1917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6521261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7722Medicare ID - Type UnspecifiedGENERAL PRACTICE