MEDICARE: H & L MEDICAL CENTER

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	363A00000X	Physician Assistant	PA 9100304	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275626806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H & L MEDICAL CENTER

Provider Business Mailing Address
First Line	:	P.O. BOX 522483
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33152-2483
Country	:	US
Telephone Number	:	305-323-1812
Fax Number	:	305-223-3579

Provider Business Practice Location Address
First Line	:	14990 S.W. 43RD STREET
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4381
Country	:	US
Telephone Number	:	305-323-1812
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN ASSISTANT
Name	:	MR. ORLANDO ENRIQUE LEIVA
Credential	:
Telephone Number	:	305-558-8687

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/12/2008

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Directions to “H & L MEDICAL CENTER ” Practice Location

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