Healthcare Provider Details

I. General information

NPI: 1952805046
Provider Name (Legal Business Name): PALMETTO HEALTH MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 W 49TH ST STE 300
HIALEAH FL
33012-2965
US

IV. Provider business mailing address

1840 W 49TH ST STE 300
HIALEAH FL
33012-2965
US

V. Phone/Fax

Practice location:
  • Phone: 305-507-0172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ADRIAN HERNANDEZ ALEMAN
Title or Position: PRESIDENT
Credential:
Phone: 305-507-0172