MEDICARE: DELFINA 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	207QA0505X	Adult Medicine Physician	HCC5085	FL

General Provider Information

NPI Number	:	1346208626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELFINA MEDICAL CENTER, INC

Provider Business Mailing Address
First Line	:	835 E 10TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4645
Country	:	US
Telephone Number	:	305-821-3620
Fax Number	:	305-821-3620

Provider Business Practice Location Address
First Line	:	835 E 10TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4645
Country	:	US
Telephone Number	:	305-821-3620
Fax Number	:	305-821-3620

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAMON A BERENGUER
Credential	:	M.D.
Telephone Number	:	305-821-3620

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	08/22/2020

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