Healthcare Provider Details

I. General information

NPI: 1801976451
Provider Name (Legal Business Name): PALMETTO GENERAL HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4715 NW 157TH ST STE 124
MIAMI GARDENS FL
33014-6435
US

IV. Provider business mailing address

4715 NW 157TH ST STE 124
MIAMI GARDENS FL
33014-6435
US

V. Phone/Fax

Practice location:
  • Phone: 305-628-0102
  • Fax: 305-628-0109
Mailing address:
  • Phone: 305-628-0102
  • Fax: 305-628-0109

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: YUMIDA NARANJO
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 786-301-7717