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General NPI Number Information
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NPI Number | 1811000193
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Entity Type | Organization
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Legal Business Name | MIAMI DADE HEALTH CENTERS
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2526 W FLAGLER ST
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City | MIAMI
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State | FL
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Zip | 33135-1423
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Country | US
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Telephone | 305-644-0067
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Fax | 305-631-9834
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Provider Business Mailing Address
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Address Line | 3233 PALM AVE
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City | HIALEAH
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State | FL
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Zip | 33012-5427
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Country | US
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Telephone | 305-642-0590
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Fax | 305-643-6326
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS CRUZ
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Credential | M.D.
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Telephone | 305-642-0590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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