Healthcare Provider Details

I. General information

NPI: 1265594717
Provider Name (Legal Business Name): MITTO HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1271 NW 6TH ST
MIAMI FL
33125-4719
US

IV. Provider business mailing address

1271 NW 6TH ST
MIAMI FL
33125-4719
US

V. Phone/Fax

Practice location:
  • Phone: 305-324-7827
  • Fax:
Mailing address:
  • Phone: 305-324-7827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MR. OTTO HEVIA
Title or Position: PRESIDENT
Credential:
Phone: 305-324-7827