Provider Demographics
NPI:1821774126
Name:OCEAN REEF MEDICAL INSTITUTE, LLC
Entity Type:Organization
Organization Name:OCEAN REEF MEDICAL INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:TREJOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-859-1918
Mailing Address - Street 1:1138 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4167
Mailing Address - Country:US
Mailing Address - Phone:786-859-1918
Mailing Address - Fax:
Practice Address - Street 1:4471 NW 36TH ST STE 230
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-7289
Practice Address - Country:US
Practice Address - Phone:786-859-1918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health