MEDICARE: H EMERGENCY ROOM VI CORP

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	261Q00000X	Clinic/Center	ME17400	FL

General Provider Information

NPI Number	:	1164859740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H EMERGENCY ROOM VI CORP

Provider Business Mailing Address
First Line	:	1231 SW 74TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-5337
Country	:	US
Telephone Number	:	786-235-2442
Fax Number	:

Provider Business Practice Location Address
First Line	:	1231 SW 74TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-5337
Country	:	US
Telephone Number	:	786-235-2442
Fax Number	:

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	MR. RAMON SANTIAGO
Credential	:	M.D.
Telephone Number	:	786-235-2442

Provider Enumeration Date	:	09/27/2013
Last Update Date	:	09/27/2013

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Directions to “H EMERGENCY ROOM VI CORP ” Practice Location

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