Provider Demographics
NPI:1790022903
Name:BRUDIA GROUP INC
Entity Type:Organization
Organization Name:BRUDIA GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-728-9418
Mailing Address - Street 1:247 SW 8TH ST
Mailing Address - Street 2:SUITE 143
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3529
Mailing Address - Country:US
Mailing Address - Phone:305-728-9418
Mailing Address - Fax:305-397-2597
Practice Address - Street 1:247 SW 8TH ST
Practice Address - Street 2:SUITE 143
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3529
Practice Address - Country:US
Practice Address - Phone:305-728-9418
Practice Address - Fax:305-397-2597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center