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General NPI Number Information
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NPI Number | 1104084730
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Entity Type | Organization
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Legal Business Name | SAMOHO HEALTHCARE EXPRESS HIALEAH LLC
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 3141 W 76TH ST
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City | HIALEAH
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State | FL
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Zip | 33018-3885
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Country | US
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Telephone | 305-665-4614
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Fax | 305-667-0239
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Provider Business Mailing Address
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Address Line | 5901 SW 74TH ST SUITE 202
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City | MIAMI
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State | FL
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Zip | 33143-5165
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Country | US
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Telephone | 305-665-4614
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Fax | 305-667-0239
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GUILLERMO ROCHIN
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Credential |
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Telephone | 305-665-4614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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