Healthcare Provider Details

I. General information

NPI: 1528156445
Provider Name (Legal Business Name): IMPERIAL HEALTH SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13780 SW 26TH ST STE 104
MIAMI FL
33175-6302
US

IV. Provider business mailing address

13780 SW 26TH ST STE 104
MIAMI FL
33175-6302
US

V. Phone/Fax

Practice location:
  • Phone: 305-480-0803
  • Fax:
Mailing address:
  • Phone: 305-480-0803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberHCC7273
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberHCC7273
License Number StateFL

VIII. Authorized Official

Name: MRS. MANUELA BORCHES
Title or Position: PRESIDENT
Credential:
Phone: 305-785-7266