Diversified American, Corp

NPI #1023256229 in Miami, Florida

Provider Information

NPI Number: 1023256229
Entity Type: Organization
Organization Name: Diversified American, Corp
Primary Specialty: Clinic/Center
Enumeration Date: Jan 26, 2009
Last Updated: Jan 26, 2009

Practice Location

Address: 14629 SW 104 ST
Address 2: SUITE 300
City: Miami
State: Florida
ZIP Code: 33186
Phone: (786) 447-0931

Authorized Official

Name: ELADIO RIVES
Title: PRESIDENT
Phone: (786) 447-0931

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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