Healthcare Provider Details

I. General information

NPI: 1295755676
Provider Name (Legal Business Name): PALM SPRINGS GENERAL HOSPITAL INC NEW CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 49TH ST
HIALEAH FL
33012-3222
US

IV. Provider business mailing address

1475 W 49TH ST
HIALEAH FL
33012-3222
US

V. Phone/Fax

Practice location:
  • Phone: 305-558-2500
  • Fax: 305-826-9002
Mailing address:
  • Phone: 305-558-2500
  • Fax: 305-826-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number4065
License Number StateFL

VIII. Authorized Official

Name: MR. TONY MILIAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 305-824-4703