MEDICARE: VEIGA MEDICAL CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center	HCC7235	FL

General Provider Information

NPI Number	:	1104923317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEIGA MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	410 W 29TH ST
Second Line	:	SUITE 410B
City	:	HIALEAH
State	:	FL
Zip	:	33012-5728
Country	:	US
Telephone Number	:	305-887-3214
Fax Number	:	305-887-3463

Provider Business Practice Location Address
First Line	:	410 W 29TH ST
Second Line	:	SUITE 410B
City	:	HIALEAH
State	:	FL
Zip	:	33012-5728
Country	:	US
Telephone Number	:	305-887-3214
Fax Number	:	305-887-3463

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JUAN MANUEL IZQUIERDO
Credential	:
Telephone Number	:	786-258-4463

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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