Healthcare Provider Details

I. General information

NPI: 1114979044
Provider Name (Legal Business Name): PRINCIPAL MEDICAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5490 PALM AVE
HIALEAH FL
33012
US

IV. Provider business mailing address

5490 PALM AVE
HIALEAH FL
33012
US

V. Phone/Fax

Practice location:
  • Phone: 305-231-7272
  • Fax: 305-231-7377
Mailing address:
  • Phone: 305-231-7272
  • Fax: 305-231-7377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MARTIN FERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-231-7272