Provider Demographics
NPI:1396259693
Name:PAULE BAZILE, LL/BAZILE MEDICAL CENTER
Entity type:Organization
Organization Name:PAULE BAZILE, LL/BAZILE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGES
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-756-8890
Mailing Address - Street 1:6464 N. MIAMI AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150
Mailing Address - Country:US
Mailing Address - Phone:305-756-8890
Mailing Address - Fax:305-758-5769
Practice Address - Street 1:6464 N. MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150
Practice Address - Country:US
Practice Address - Phone:305-756-8890
Practice Address - Fax:305-758-5769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty