Healthcare Provider Details

I. General information

NPI: 1669851663
Provider Name (Legal Business Name): DHM MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 W FLAGLER ST STE 102
MIAMI FL
33135-5600
US

IV. Provider business mailing address

2140 W FLAGLER ST STE 102
MIAMI FL
33135-5600
US

V. Phone/Fax

Practice location:
  • Phone: 786-238-1640
  • Fax: 305-504-2737
Mailing address:
  • Phone: 786-238-1640
  • Fax: 305-504-2737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: DOMINGO HERRERA
Title or Position: OWNER
Credential:
Phone: 786-238-1640