MEDICARE: WESTCHESTER 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	208D00000X	General Practice Physician	ME66407	FL

General Provider Information

NPI Number	:	1194798694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTCHESTER MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	8820 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-2008
Country	:	US
Telephone Number	:	305-559-8484
Fax Number	:	305-559-9795

Provider Business Practice Location Address
First Line	:	8820 SW 24TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-2008
Country	:	US
Telephone Number	:	305-559-8484
Fax Number	:	305-559-9795

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALEIDA MAXIMA HERNANDEZ
Credential	:	M.D.
Telephone Number	:	305-559-8484

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	08/22/2020

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