Healthcare Provider Details

I. General information

NPI: 1154716918
Provider Name (Legal Business Name): HIALEAH EXCELLENCE MEDICAL CENTER,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 W 49TH ST SUITE 420
HIALEAH FL
33012-2942
US

IV. Provider business mailing address

1840 W 49TH ST SUITE 420
HIALEAH FL
33012-2942
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-3000
  • Fax:
Mailing address:
  • Phone: 305-823-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME47219
License Number StateFL

VIII. Authorized Official

Name: MRS. ANA M AEL
Title or Position: C.E.O
Credential:
Phone: 305-823-3000