Healthcare Provider Details

I. General information

NPI: 1093093726
Provider Name (Legal Business Name): THE MEDICAL CITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2011
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3595 W 20TH AVE STE 145
HIALEAH FL
33012-4537
US

IV. Provider business mailing address

780 NW 42ND AVE STE 301
MIAMI FL
33126-5536
US

V. Phone/Fax

Practice location:
  • Phone: 305-557-4424
  • Fax: 305-557-4426
Mailing address:
  • Phone: 786-422-6821
  • Fax: 786-422-6855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ELIZABETH BRACERAS
Title or Position: PRESIDENT
Credential:
Phone: 308-889-5332