Provider Demographics
NPI:1730126186
Name:QUALMED OF MIAMI, INC.
Entity type:Organization
Organization Name:QUALMED OF MIAMI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PALACIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-398-0807
Mailing Address - Street 1:2901 NW 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-6631
Mailing Address - Country:US
Mailing Address - Phone:305-633-3015
Mailing Address - Fax:305-634-9118
Practice Address - Street 1:2901 NW 17TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-6631
Practice Address - Country:US
Practice Address - Phone:305-633-3015
Practice Address - Fax:305-634-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF70213Medicare UPIN
FLE27833Medicare UPIN
FLK2248Medicare ID - Type UnspecifiedQUALMED OF MIAMI, INC.
FL01561ZMedicare ID - Type UnspecifiedMANUEL POUPARINA, MD