RAFAEL L. NOGUES MD PA
Osteopathic Medicine at 87 Ave, Miami, FL

License number
Florida ME69090
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: RAFAEL L NOGUES MD
Title: PRESIDENT
Phone: (305) 665-2812
Address
Address
5021 SW 87Th Ave, Miami, FL 33165
National Provider ID: 1205938396
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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RAFAEL L. NOGUES, M.D., PA

Miami, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jun 25, 2004
Inactive since:
Sep 27, 2013
Addresses:
5775 Blue Lagoon Dr 190, Miami, FL 33126 (Physical)
5021 SW 87 Ave, Miami, FL 33165 (Mailing)
5775 Blue Lagoon Dr, Miami, FL 33126
State ID:
P04000096840
Business type:
Florida Profit Corporation
President, Secretary:
Rafael L Nogues President, Secretary, inactive, 5775 Blue Lagoon Dr SUITE #190, Miami, FL 33126 (Physical)
Agent:
Maria Nogues,5021 SW 87 Ave, Miami, FL 33165 (Physical)
EIN:
201290800

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