Healthcare Provider Details
I. General information
NPI: 1578146668
Provider Name (Legal Business Name): CIFRAT MEDICAL CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2021
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13499 BISCAYNE BLVD STE 105
NORTH MIAMI FL
33181-2035
US
IV. Provider business mailing address
345 W 62ND ST
HIALEAH FL
33012-2647
US
V. Phone/Fax
- Phone: 786-357-2703
- Fax:
- Phone: 786-357-2703
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEOSVANIS
CIFRAT ALONSO
Title or Position: PRESIDENT
Credential:
Phone: 786-357-2703