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General NPI Number Information
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NPI Number | 1861183287
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Entity Type | Organization
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Legal Business Name | LIFE HEART MEDICAL CENTER
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 923 W 29TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-5610
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Country | US
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Telephone | 786-616-8932
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Fax |
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Provider Business Mailing Address
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Address Line | 923 W 29TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-5610
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Country | US
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Telephone | 786-332-9466
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | ERIC MILLER
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Credential | MD
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Telephone | 786-616-8932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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