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NPI Code Detail

MEDICARE: MEMORIAL HEALTHCARE SYSTEM

MEDICARE: MEMORIAL HEALTHCARE SYSTEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282NC0060XCritical Access HospitalME98204FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME98204OTHERFLFLORIDA LICENSE

General Provider Information

NPI Number : 1477670099
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEMORIAL HEALTHCARE SYSTEM
Provider Business Mailing Address
First Line : 1150 N 35TH AVE
Second Line : SUITE 499
City : HOLLYWOOD
State : FL
Zip : 33021-5424
Country : US
Telephone Number : 954-985-6941
Fax Number : 954-965-3599
Provider Business Practice Location Address
First Line : 100 LINCOLN RD
Second Line : APT 338
City : MIAMI BEACH
State : FL
Zip : 33139-2013
Country : US
Telephone Number : 305-672-4187
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : MR. JESUS E PIRIZ
Credential :
Telephone Number : 954-987-2020
Provider Enumeration Date : 03/26/2007
Last Update Date : 08/22/2020

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Directions to “MEMORIAL HEALTHCARE SYSTEM ” Practice Location

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