MEDICARE: HIALEAH HEALTH INSTITUTE 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	261QH0100X	Health Service Clinic/Center		FL

General Provider Information

NPI Number	:	1881080687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIALEAH HEALTH INSTITUTE CORP

Provider Business Mailing Address
First Line	:	2400 PALM AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-1721
Country	:	US
Telephone Number	:	786-547-9626
Fax Number	:	305-504-2737

Provider Business Practice Location Address
First Line	:	2400 PALM AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-1721
Country	:	US
Telephone Number	:	786-547-9626
Fax Number	:	305-504-2737

Authorized Official
Title or Position	:	OWNER
Name	:	LAZARO LUIS QUINTANA
Credential	:
Telephone Number	:	786-547-9626

Provider Enumeration Date	:	04/09/2015
Last Update Date	:	04/09/2015

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Directions to “HIALEAH HEALTH INSTITUTE CORP ” Practice Location

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