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General NPI Number Information
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NPI Number | 1558677633
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Entity Type | Organization
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Legal Business Name | USA FLORIDA MEDICAL CENTER
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 1490 W 49TH PL STE 370
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City | HIALEAH
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State | FL
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Zip | 33012-3148
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Country | US
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Telephone | 305-820-0017
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Fax | 305-820-0018
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Provider Business Mailing Address
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Address Line | 1490 W 49TH PL STE 370
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City | HIALEAH
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State | FL
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Zip | 33012-3148
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Country | US
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Telephone | 305-820-0017
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Fax | 305-820-0018
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE CRUZ
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Credential |
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Telephone | 305-820-0017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | HCC8822
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License Number State | FL
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