Healthcare Provider Details

I. General information

NPI: 1184643215
Provider Name (Legal Business Name): DALEMA MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 EAST HALLANDALE BEACH BLVD 622
HALLANDALE BEACH FL
33009
US

IV. Provider business mailing address

600 EAST HALLANDALE BEACH BLVD 622
HALLANDALE BEACH FL
33009
US

V. Phone/Fax

Practice location:
  • Phone: 786-380-9603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LENIN RIVERO
Title or Position: PRESIDENT
Credential:
Phone: 786-380-9603