Healthcare Provider Details

I. General information

NPI: 1942467428
Provider Name (Legal Business Name): WEST TECHNICAL SERVICE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 W 50TH ST SUITE 310
HIALEAH FL
33012-3440
US

IV. Provider business mailing address

1140 W 50TH ST SUITE 310
HIALEAH FL
33012-3440
US

V. Phone/Fax

Practice location:
  • Phone: 305-558-4020
  • Fax: 305-558-7060
Mailing address:
  • Phone: 305-558-4020
  • Fax: 305-558-7060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. RELVIS HERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 305-558-4020