Basic Information
| Provider Information | |||||||||
| NPI: | 1427370436 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AIRPORT MD-MIAMI LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5741 SOUTHLAND DR | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366933307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007000278 | ||||||||
| FaxNumber: | 2516668398 | ||||||||
| Practice Location | |||||||||
| Address1: | 4200 NW 21ST STREET | ||||||||
| Address2: | MIAMI INTERNATIONAL AIRPORT-CONCOURSE H | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058694075 | ||||||||
| FaxNumber: | 3058694076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2010 | ||||||||
| LastUpdateDate: | 02/17/2010 | ||||||||
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| AuthorizedOfficialLastName: | PATRICK | ||||||||
| AuthorizedOfficialFirstName: | RACHEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 2516026996 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | 23-8015240864-1 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.