Basic Information
| Provider Information | |||||||||
| NPI: | 1366465379 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL CENTER OF WINSTON TOWERS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2845 AVENTURA BLVD | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331803118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059319002 | ||||||||
| FaxNumber: | 3056929176 | ||||||||
| Practice Location | |||||||||
| Address1: | 2845 AVENTURA BLVD | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331803118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059319002 | ||||||||
| FaxNumber: | 3056929176 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 07/16/2008 | ||||||||
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| AuthorizedOfficialLastName: | HOROWITZ | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3055387344 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.