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General NPI Number Information
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NPI Number | 1659477263
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Entity Type | Organization
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Legal Business Name | DOS OF HIALEAH, INC
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 01/25/2012
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Provider Practice Location Address
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Address Line | 8785 NW 32ND AVE
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City | MIAMI
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State | FL
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Zip | 33147-3705
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Country | US
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Telephone | 305-691-5711
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Fax | 305-691-6707
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Provider Business Mailing Address
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Address Line | 8785 NW 32ND AVE
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City | MIAMI
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State | FL
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Zip | 33147-3705
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Country | US
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Telephone | 305-691-5711
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Fax | 305-691-6707
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Authorized Official
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Title or Position | OWNER
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Name | MR. JORGE R HERNANDO
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Credential |
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Telephone | 305-868-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF1399096
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License Number State | FL
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