=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225246804
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIRST HEALTH CARE MIAMI INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6175 NW 153RD ST SUITE 301
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-2435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-558-9522
-----------------------------------------------------
Fax | 305-558-9520
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6175 NW 153RD ST SUITE 301
-----------------------------------------------------
City | MIAMI LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33014-2435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-558-9522
-----------------------------------------------------
Fax | 305-558-9520
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JULIO PRADO
-----------------------------------------------------
Credential | P.A.
-----------------------------------------------------
Telephone | 305-558-9522
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------