MEDICARE: HEALTHPARK 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

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	:	1306387303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHPARK MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	2853 EXECUTIVE PARK DR STE 104
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3656
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2853 EXECUTIVE PARK DR STE 104
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3656
Country	:	US
Telephone Number	:	786-615-7164
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FEDERICO MARTINEZ
Credential	:
Telephone Number	:	954-573-5464

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	02/12/2026

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