Healthcare Provider Details

I. General information

NPI: 1205193836
Provider Name (Legal Business Name): PASTEUR MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4578 W 12TH AVE
HIALEAH FL
33012-3325
US

IV. Provider business mailing address

4578 W 12TH AVE
HIALEAH FL
33012-3325
US

V. Phone/Fax

Practice location:
  • Phone: 305-828-1989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TARIK HAWATMEH
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 786-422-6821