Healthcare Provider Details

I. General information

NPI: 1982911269
Provider Name (Legal Business Name): SOUTH FLORIDA HEALTH MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 GRAND CANAL DR SUITE 301
MIAMI FL
33144-2561
US

IV. Provider business mailing address

85 GRAND CANAL DR SUITE 301
MIAMI FL
33144-2561
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-2629
  • Fax: 305-262-2829
Mailing address:
  • Phone: 305-262-2629
  • Fax: 305-262-2829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberHCC8492
License Number StateFL

VIII. Authorized Official

Name: JOHN G PADRON
Title or Position: PRESIDENT
Credential: MD
Phone: 305-262-2629