Provider Demographics
NPI:1811653355
Name:FLORIDIAN PHYSICIANS MANAGEMENT
Entity type:Organization
Organization Name:FLORIDIAN PHYSICIANS MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:QUEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-240-2461
Mailing Address - Street 1:4960 SW 72ND AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5549
Mailing Address - Country:US
Mailing Address - Phone:305-240-2461
Mailing Address - Fax:
Practice Address - Street 1:9930 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3944
Practice Address - Country:US
Practice Address - Phone:305-240-2461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty