Healthcare Provider Details

I. General information

NPI: 1376940460
Provider Name (Legal Business Name): MIAMI HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2014
Last Update Date: 12/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 E 8TH AVE
HIALEAH FL
33010-5116
US

IV. Provider business mailing address

2645 SW 37TH AVE STE 502
MIAMI FL
33133-2744
US

V. Phone/Fax

Practice location:
  • Phone: 305-448-2188
  • Fax:
Mailing address:
  • Phone: 305-448-8134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberOS0004172
License Number StateFL

VIII. Authorized Official

Name: HARRIS MONES
Title or Position: PRESIDENT
Credential: DO
Phone: 305-448-8134