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General NPI Number Information
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NPI Number | 1952904195
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Entity Type | Organization
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Legal Business Name | MEDISANA HEALTH CENTER CORP
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 5391 NW 36TH ST
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5924
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Country | US
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Telephone | 786-636-1310
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Fax | 786-636-1311
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Provider Business Mailing Address
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Address Line | 5391 NW 36TH ST
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5924
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Country | US
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Telephone | 786-636-1310
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Fax | 786-636-1311
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Authorized Official
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Title or Position | OWNER
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Name | MS. GLEIDYS SOTO ALONSO
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Credential |
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Telephone | 305-799-3112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 364SP0812X
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Taxonomy Name | Community Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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