54TH STREET MEDICAL PLAZA INC
Medical Practice at 2 Ave, Miami, FL

License number
Florida ME60686
Category
Medical Practice
Type
Pediatrics
Owner
Name: GEMMA ROSELLO
Title: VICE PRESIDENT
Phone: (305) 500-2109
Address
Address
5305 NE 2Nd Ave, Miami, FL 33137
National Provider ID: 1497007173
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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54th Street Medical Plaza, Inc

Louisville, KY  -  Miami, FL

Industry:
Medical Clinic
Doing business as:
54TH Street Medical Plaza
Inactive reason:
AMENDMENT
Registration:
Oct 28, 1991
Inactive since:
Mar 4, 2013
Phone:
(305) 756-9977 (Phone)
Addresses:
500 W Main St, Louisville, KY 40202
5385 NE 2 Ave, Miami, FL 33137
State ID:
S90075
Business type:
Florida Profit Corporation
President, Secretarys:
James E. Murray (Director),Joan O. Lenahan (Vice President),Bruce D. Broussard (Director),...
Agent:
Corporation Service Company,1201 Hays St, Tallahassee, FL 32301 (Physical)
EIN:
650293220

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