Healthcare Provider Details

I. General information

NPI: 1477742765
Provider Name (Legal Business Name): MEDCHOICE OF NORTH HIALEAH, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1578 WEST 68 STREET
HIALEAH FL
33014
US

IV. Provider business mailing address

P.O. BOX 141799
CORAL GABLES FL
33114-1799
US

V. Phone/Fax

Practice location:
  • Phone: 305-557-3889
  • Fax: 305-557-8830
Mailing address:
  • Phone: 305-557-3889
  • Fax: 305-557-8830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ARMANDO E. ACEVEDO, M.D.
Title or Position: OWNER
Credential: M.D.
Phone: 305-975-4036