Healthcare Provider Details

I. General information

NPI: 1215093075
Provider Name (Legal Business Name): AMEDICA CHILDREN'S CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 E 49TH ST
HIALEAH FL
33013-1963
US

IV. Provider business mailing address

625 E 49TH ST
HIALEAH FL
33013-1963
US

V. Phone/Fax

Practice location:
  • Phone: 305-681-7770
  • Fax: 305-681-7968
Mailing address:
  • Phone: 305-681-7770
  • Fax: 305-681-7968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARMEN A MOLINA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 305-681-7770