Provider Demographics
NPI:1588995120
Name:HIGH TOWER SERVICE
Entity type:Organization
Organization Name:HIGH TOWER SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:AMADOR
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-339-4555
Mailing Address - Street 1:1421 SW 107TH AVE
Mailing Address - Street 2:SUITE 262
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2526
Mailing Address - Country:US
Mailing Address - Phone:786-339-4555
Mailing Address - Fax:
Practice Address - Street 1:1421 SW 107TH AVE
Practice Address - Street 2:SUITE 262
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2526
Practice Address - Country:US
Practice Address - Phone:786-339-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty