Healthcare Provider Details
I. General information
NPI: 1205657624
Provider Name (Legal Business Name): PASTEUR & WELLMAX MEDICAL CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2024
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5740 NW 183RD ST
HIALEAH FL
33015-6021
US
IV. Provider business mailing address
6355 SW 36 AVE EAST BUILDING, STE 1100
VIRGINIA GARDENS FL
33166
US
V. Phone/Fax
- Phone: 305-722-8565
- Fax: 305-722-8561
- Phone: 786-233-6981
- Fax: 786-322-2317
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JORGE
RAAD
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 786-233-6981