Provider Demographics
NPI:1467005116
Name:MIAMI MENS HEALTH
Entity Type:Organization
Organization Name:MIAMI MENS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:716-208-6781
Mailing Address - Street 1:2263 SW 37TH AVE APT 441
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3262
Mailing Address - Country:US
Mailing Address - Phone:716-208-6781
Mailing Address - Fax:
Practice Address - Street 1:135 SAN LORENZO AVE STE 540
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1880
Practice Address - Country:US
Practice Address - Phone:305-444-2290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty