Healthcare Provider Details

I. General information

NPI: 1770751547
Provider Name (Legal Business Name): PLATINUM HOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18960 NW 57TH AVE # 205
HIALEAH FL
33015-7071
US

IV. Provider business mailing address

18960 NW 57TH AVE # 205
HIALEAH FL
33015-7071
US

V. Phone/Fax

Practice location:
  • Phone: 786-597-1108
  • Fax:
Mailing address:
  • Phone: 786-597-1108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number230234
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number230234
License Number StateFL

VIII. Authorized Official

Name: MS. CIRIA HERNANDEZ
Title or Position: PRESIDENT
Credential:
Phone: 786-597-1108