Healthcare Provider Details

I. General information

NPI: 1629098017
Provider Name (Legal Business Name): MIAMI DADE HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16800 NW 2ND AVE STE. 103
NORTH MIAMI BEACH FL
33169-5549
US

IV. Provider business mailing address

3233 PALM AVE
HIALEAH FL
33012-5427
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-8770
  • Fax: 305-651-7898
Mailing address:
  • Phone: 305-642-0590
  • Fax: 305-643-6326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: LUIS CRUZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-642-0590