MEDICARE: HEALTH MIAMI 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1518493121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH MIAMI MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	897 SW 86TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4028
Country	:	US
Telephone Number	:	786-482-8844
Fax Number	:	786-534-9750

Provider Business Practice Location Address
First Line	:	897 SW 86TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4028
Country	:	US
Telephone Number	:	786-482-8844
Fax Number	:	786-534-9750

Authorized Official
Title or Position	:	OWNER
Name	:	ALEX BORRERO
Credential	:	M.T
Telephone Number	:	786-482-8844

Provider Enumeration Date	:	05/03/2017
Last Update Date	:	05/03/2017

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