Healthcare Provider Details

I. General information

NPI: 1013672690
Provider Name (Legal Business Name): WESTCHESTER GENERAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 11/08/2021
Certification Date: 10/21/2021
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 TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

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