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General NPI Number Information
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NPI Number | 1386136570
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Entity Type | Organization
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Legal Business Name | SURAMED HEALTH CENTER, PA
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 6293 LAKE WORTH RD
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City | GREENACRES
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State | FL
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Zip | 33463
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Country | US
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Telephone | 561-812-1271
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Fax | 561-964-4050
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Provider Business Mailing Address
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Address Line | 6293 LAKE WORTH RD
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City | GREENACRES
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State | FL
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Zip | 33463
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Country | US
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Telephone | 561-812-1271
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Fax |
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. ALFONSO J HENRIQUEZ
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Credential | MD
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Telephone | 561-812-1271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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