Healthcare Provider Details

I. General information

NPI: 1144383597
Provider Name (Legal Business Name): SAN DIEGO MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 TAFT ST SUITE 303
HOLLYWOOD FL
33024-4040
US

IV. Provider business mailing address

6600 TAFT ST SUITE 303
HOLLYWOOD FL
33024-4040
US

V. Phone/Fax

Practice location:
  • Phone: 786-546-2122
  • Fax:
Mailing address:
  • Phone: 786-546-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number
License Number State

VIII. Authorized Official

Name: RODOLFO RAMIREZ
Title or Position: PRESIDENT
Credential:
Phone: 786-512-4144