Healthcare Provider Details

I. General information

NPI: 1518631647
Provider Name (Legal Business Name): WESTCHESTER GENERAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 08/03/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 SW 75TH AVE
MIAMI FL
33155-2805
US

IV. Provider business mailing address

2500 SW 75TH AVE
MIAMI FL
33155-2805
US

V. Phone/Fax

Practice location:
  • Phone: 305-264-5252
  • Fax: 305-267-6920
Mailing address:
  • Phone: 305-264-5252
  • Fax: 305-267-6920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY VALDES
Title or Position: DIRECTOR OF ADMINISTRATIVE SERVICES
Credential:
Phone: 305-264-5252