Healthcare Provider Details

I. General information

NPI: 1104084730
Provider Name (Legal Business Name): SAMOHO HEALTHCARE EXPRESS HIALEAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 05/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 W 76TH ST
HIALEAH FL
33018-3885
US

IV. Provider business mailing address

5901 SW 74TH ST SUITE 202
MIAMI FL
33143-5165
US

V. Phone/Fax

Practice location:
  • Phone: 305-665-4614
  • Fax: 305-667-0239
Mailing address:
  • Phone: 305-665-4614
  • Fax: 305-667-0239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. GUILLERMO ROCHIN
Title or Position: PRESIDENT
Credential:
Phone: 305-665-4614