Provider Demographics
NPI:1811522618
Name:MV528 CORP
Entity type:Organization
Organization Name:MV528 CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALERIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-641-4261
Mailing Address - Street 1:4100 SW 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5319
Mailing Address - Country:US
Mailing Address - Phone:305-856-1064
Mailing Address - Fax:305-856-0644
Practice Address - Street 1:4100 SW 57TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5319
Practice Address - Country:US
Practice Address - Phone:305-856-1064
Practice Address - Fax:305-856-0644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty