MEDICARE: MEGA HEALTH CENTER EAST HIALEAH 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		FL

General Provider Information

NPI Number	:	1306101522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEGA HEALTH CENTER EAST HIALEAH INC

Provider Business Mailing Address
First Line	:	551 E 49TH ST
Second Line	:	STE 1-8
City	:	HIALEAH
State	:	FL
Zip	:	33013-1904
Country	:	US
Telephone Number	:	305-245-9990
Fax Number	:	305-245-9951

Provider Business Practice Location Address
First Line	:	551 E 49TH ST
Second Line	:	STE 1-8
City	:	HIALEAH
State	:	FL
Zip	:	33013-1904
Country	:	US
Telephone Number	:	305-245-9990
Fax Number	:	305-245-9951

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. SONIA I RENTE
Credential	:	M.D.
Telephone Number	:	305-245-9990

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	07/13/2012

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