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General NPI Number Information
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NPI Number | 1407439078
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Entity Type | Organization
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Legal Business Name | SINA MEDICAL CENTER LLC
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 1541 SE 12TH AVE STE 29
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City | HOMESTEAD
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State | FL
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Zip | 33034-2699
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Country | US
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Telephone | 786-640-1424
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Fax | 786-601-7124
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Provider Business Mailing Address
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Address Line | 1541 SE 12TH AVE STE 29
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City | HOMESTEAD
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State | FL
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Zip | 33034-2699
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Country | US
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Telephone | 786-640-1424
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Fax | 786-601-7124
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Authorized Official
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Title or Position | PRESIDENT/MANAGER
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Name | LAZARO A CASTRO
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Credential |
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Telephone | 786-719-5201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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