Provider Demographics
NPI:1932985470
Name:ABRAHAM ALFONSO REMIGIO MDPA.
Entity Type:Organization
Organization Name:ABRAHAM ALFONSO REMIGIO MDPA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFONSO REMIGIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-492-3744
Mailing Address - Street 1:5610 CASTLEGATE AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3263
Mailing Address - Country:US
Mailing Address - Phone:305-492-3744
Mailing Address - Fax:
Practice Address - Street 1:730 SE 8TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5660
Practice Address - Country:US
Practice Address - Phone:305-492-3744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care