Healthcare Provider Details
I. General information
NPI: 1275467870
Provider Name (Legal Business Name): ENCANTO HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8356 SW 40TH ST STE L
MIAMI FL
33155-3356
US
IV. Provider business mailing address
8356 SW 40TH ST STE L
MIAMI FL
33155-3356
US
V. Phone/Fax
- Phone: 786-843-1614
- Fax:
- Phone: 786-843-1614
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MADELYN
VALDES
Title or Position: MBR/OWNER
Credential:
Phone: 786-843-1614