Provider Demographics
NPI:1689331472
Name:KLASS MIAMI MEDICAL CENTER
Entity Type:Organization
Organization Name:KLASS MIAMI MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEREKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ST CYR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-502-3867
Mailing Address - Street 1:500 GULFSTREAM BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-6142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5745
Practice Address - Country:US
Practice Address - Phone:786-220-5501
Practice Address - Fax:786-490-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty