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General NPI Number Information
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NPI Number | 1245577592
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER OF HOMESTEAD PA
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 830 N KROME AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-4407
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Country | US
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Telephone | 305-255-0098
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Fax | 305-255-3466
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Provider Business Mailing Address
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Address Line | 8750 SW 144TH ST SUITE 203
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7296
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Country | US
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Telephone | 305-255-0098
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Fax | 305-255-3466
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL FELDMAN
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Credential | DO
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Telephone | 305-255-0098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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