Healthcare Provider Details

I. General information

NPI: 1275241093
Provider Name (Legal Business Name): LA EXCELENCIA MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13226 SW 8TH ST
MIAMI FL
33184-1176
US

IV. Provider business mailing address

13226 SW 8TH ST
MIAMI FL
33184-1176
US

V. Phone/Fax

Practice location:
  • Phone: 305-439-4877
  • Fax: 786-633-5130
Mailing address:
  • Phone: 305-439-4877
  • Fax: 786-633-5130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OSMANI RAMIREZ
Title or Position: OWNER
Credential:
Phone: 786-315-0244