Healthcare Provider Details

I. General information

NPI: 1740650654
Provider Name (Legal Business Name): MENENDEZ GENERAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 72ND ST SUITE 185
MIAMI FL
33173-3012
US

IV. Provider business mailing address

10300 SW 72ND ST SUITE 185
MIAMI FL
33173-3012
US

V. Phone/Fax

Practice location:
  • Phone: 786-502-8096
  • Fax: 786-420-5238
Mailing address:
  • Phone: 786-502-8096
  • Fax: 786-420-5238

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: DENIA PELLITERO ROMERO
Title or Position: OWNER
Credential:
Phone: 786-502-8096