MEDICARE: HIALEAH MEDICAL CENTER CORP

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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1518006923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIALEAH MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	555 E 25TH ST
Second Line	:	SUITE 212
City	:	HIALEAH
State	:	FL
Zip	:	33013-3848
Country	:	US
Telephone Number	:	305-696-7500
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 E 25TH ST
Second Line	:	SUITE 212
City	:	HIALEAH
State	:	FL
Zip	:	33013-3848
Country	:	US
Telephone Number	:	305-696-7500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. EVETTE MADERA
Credential	:
Telephone Number	:	305-696-7500

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	04/20/2008

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Directions to “HIALEAH MEDICAL CENTER CORP ” Practice Location

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