Provider Demographics
NPI:1740787951
Name:THE MIAMI INSTITUTE FOR RHEUMATOLOGY INC.
Entity Type:Organization
Organization Name:THE MIAMI INSTITUTE FOR RHEUMATOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YELLIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-415-9639
Mailing Address - Street 1:12780 SW 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-6239
Mailing Address - Country:US
Mailing Address - Phone:787-415-9639
Mailing Address - Fax:620-419-2656
Practice Address - Street 1:9299 SW 152ND ST STE 205
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1776
Practice Address - Country:US
Practice Address - Phone:305-901-6890
Practice Address - Fax:305-901-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL124445207RR0500X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1083846893Medicaid