Healthcare Provider Details

I. General information

NPI: 1851588396
Provider Name (Legal Business Name): PCM MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 09/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 E 9TH ST
HIALEAH FL
33010-4553
US

IV. Provider business mailing address

731 E 9TH ST
HIALEAH FL
33010-4553
US

V. Phone/Fax

Practice location:
  • Phone: 305-863-2060
  • Fax: 305-863-2027
Mailing address:
  • Phone: 305-863-2060
  • Fax: 305-863-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: OSVALDO RICARDO
Title or Position: PRESIDENT
Credential:
Phone: 305-863-2060