Provider Demographics
NPI:1669654471
Name:MAGNIFICO PC
Entity Type:Organization
Organization Name:MAGNIFICO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VLADIMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-547-2725
Mailing Address - Street 1:404 SW 19TH RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-1314
Mailing Address - Country:US
Mailing Address - Phone:786-547-2725
Mailing Address - Fax:
Practice Address - Street 1:3990 W FLAGLER ST
Practice Address - Street 2:SUITE 500
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1644
Practice Address - Country:US
Practice Address - Phone:786-547-2725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88429261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service