Provider Demographics
NPI:1881361640
Name:AZURI LLC
Entity type:Organization
Organization Name:AZURI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HINCAPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-770-6065
Mailing Address - Street 1:300 W 41ST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3627
Mailing Address - Country:US
Mailing Address - Phone:305-770-6065
Mailing Address - Fax:
Practice Address - Street 1:300 W 41ST ST STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3627
Practice Address - Country:US
Practice Address - Phone:305-770-6065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7241962OtherLOCAL BUSINESS TAX