MEDICARE: HIALEAH ACCIDENT 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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1144870049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIALEAH ACCIDENT CENTER, INC.

Provider Business Mailing Address
First Line	:	777 E 25TH ST STE 306
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3849
Country	:	US
Telephone Number	:	786-502-4945
Fax Number	:	786-558-7451

Provider Business Practice Location Address
First Line	:	777 E 25TH ST STE 306
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-3849
Country	:	US
Telephone Number	:	786-502-4945
Fax Number	:	786-558-7451

Authorized Official
Title or Position	:	PDST
Name	:	DR. DEAN ZUSMER
Credential	:	DC
Telephone Number	:	786-502-4945

Provider Enumeration Date	:	09/13/2019
Last Update Date	:	09/13/2019

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