Healthcare Provider Details

I. General information

NPI: 1427220813
Provider Name (Legal Business Name): HOOVER FAMILY MEDICINE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2008
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 SW 69TH AVE
MIAMI FL
33155-2919
US

IV. Provider business mailing address

7371 SW 24TH ST
MIAMI FL
33155-1402
US

V. Phone/Fax

Practice location:
  • Phone: 305-265-4441
  • Fax:
Mailing address:
  • Phone: 305-265-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KEILA HOOVER
Title or Position: OWNER
Credential: M.D.
Phone: 305-265-4441