Healthcare Provider Details

I. General information

NPI: 1013021633
Provider Name (Legal Business Name): VENANC MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 E 9TH ST SUITE 202
HIALEAH FL
33010-4216
US

IV. Provider business mailing address

342 E 9TH ST SUITE 202
HIALEAH FL
33010-4216
US

V. Phone/Fax

Practice location:
  • Phone: 786-319-0698
  • Fax: 305-805-8566
Mailing address:
  • Phone: 786-319-0698
  • Fax: 305-805-8566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MR. ECNAR REINOSO
Title or Position: PRESIDENT
Credential:
Phone: 786-319-0698