HUMBERTO BASTO MD PA
Radiology at 27 Ct, Miami, FL

License number
Florida ME0036969
Category
Radiology
Type
Surgery
Owner
Name: HUMBERTO BASTO MD PA
Title: PRESIDENT
Phone: (305) 940-0068
Address
Address
21097 NE 27Th Ct SUITE 210, Miami, FL 33180
National Provider ID: 1336101880
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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HUMBERTO BASTO, M.D., PA

Miami, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
CANCEL ADM DISS/REV
Registration:
Jul 18, 1985
Inactive since:
Apr 5, 2004
Addresses:
2300 NE 215, Miami, FL 33180 (Physical)
2300 NE 215 St, Miami, FL 33180
State ID:
M18249
Business type:
Florida Profit Corporation
President:
Humberto Basto (President), 2300 NE 215, Miami, FL 33180 (Physical)
Agent:
Basto, Humberto,2300 NE 215, Miami, FL 33180 (Physical)
EIN:
592605839

Humberto Basto MD PA

1380 NE Miami Gdn Dr, Miami, FL 33179

Status:
Inactive
Industry:
Medical Doctor's Office

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