=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801292651
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HONOR HEALTH CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2014
-----------------------------------------------------
Last Update Date | 11/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8700 WEST FLAGLER ST SUITE 285
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33174
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-464-0462
-----------------------------------------------------
Fax | 786-464-0475
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8700 WEST FLAGLER ST SUITE 285
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33174
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-464-0462
-----------------------------------------------------
Fax | 786-464-0475
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | IVAN GONZALEZ PADRINO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-464-0462
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------