Edl 66 Corp

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

EDL 66 CORP

Practice address

4711 NW 79TH Ave Ste 6F
Doral, FL 33166-5439

Phone

(786) 558-9009

NPI assigned

Jan 30, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ezequiel Diaz Lopez

Title

Owner

Phone

(786) 558-9009

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1548073745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 NW 79TH AVE STE 6F",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331665439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 NW 79TH AVE STE 6F",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331665439",
            "telephone_number": "786-558-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDL 66 CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "DIAZ LOPEZ",
        "authorized_official_first_name": "EZEQUIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-558-9009"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Doral, FL
• Providers in Doral, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.