Basic Information
| Provider Information | |||||||||
| NPI: | 1801032107 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UIVERSITY OF MIAMI | ||||||||
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| OtherOrganizationName: | UMDC- DIVISION OF PEDIATRICS GENETICS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1121 NW 14TH ST | ||||||||
| Address2: | SUITE # 103 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052436837 | ||||||||
| FaxNumber: | 3052438470 | ||||||||
| Practice Location | |||||||||
| Address1: | 1601 NW 12TH AVE | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331361005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052436837 | ||||||||
| FaxNumber: | 3052438470 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2008 | ||||||||
| LastUpdateDate: | 12/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | ROMILLO | ||||||||
| AuthorizedOfficialFirstName: | GEMMA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF BILLING COMPLIANCE | ||||||||
| AuthorizedOfficialTelephone: | 3052436837 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207SC0300X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Cytogenetic |
No ID Information.