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General NPI Number Information
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NPI Number | 1073403119
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Entity Type | Organization
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Legal Business Name | OHANA MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 190 NW 14TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33030-4240
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Country | US
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Telephone | 786-404-3442
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Fax | 786-404-3104
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Provider Business Mailing Address
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Address Line | 190 NW 14TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33030-4240
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Country | US
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Telephone | 786-404-3442
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Fax | 786-404-3104
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LUDMILA DE LA CONCEPCION
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Credential | MD
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Telephone | 786-404-3442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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