Healthcare Provider Details
I. General information
NPI: 1992585251
Provider Name (Legal Business Name): WESTCHESTER GENERAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/04/2023
Last Update Date: 10/04/2023
Certification Date: 10/02/2023
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
- Phone: 305-264-5252
- Fax:
- Phone: 305-264-5252
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARY
HELEN FLORES
Title or Position: DIRECTOR OF ADMINISTRATIVE SERVICES
Credential:
Phone: 305-264-5252