Provider Demographics
NPI:1861798282
Name:ASSOCIATES IN ADVANCED MATERNAL FETAL MEDICINE, LLC
Entity type:Organization
Organization Name:ASSOCIATES IN ADVANCED MATERNAL FETAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ-QUINTERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-274-5229
Mailing Address - Street 1:7765 SW 87TH AVE
Mailing Address - Street 2:SUITE 200 A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2596
Mailing Address - Country:US
Mailing Address - Phone:305-274-5229
Mailing Address - Fax:305-274-5751
Practice Address - Street 1:7765 SW 87TH AVE
Practice Address - Street 2:SUITE 200 A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2596
Practice Address - Country:US
Practice Address - Phone:305-274-5229
Practice Address - Fax:305-274-5751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VITAL MD GROUP HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68545207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty