MEDICARE: MEDCHOICE OF NORTH HIALEAH, L.L.C.

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	173000000X	Legal Medicine

General Provider Information

NPI Number	:	1477742765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCHOICE OF NORTH HIALEAH, L.L.C.

Provider Business Mailing Address
First Line	:	P.O. BOX 141799
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33114-1799
Country	:	US
Telephone Number	:	305-557-3889
Fax Number	:	305-557-8830

Provider Business Practice Location Address
First Line	:	1578 WEST 68 STREET
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014
Country	:	US
Telephone Number	:	305-557-3889
Fax Number	:	305-557-8830

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ARMANDO E. ACEVEDO, M.D.
Credential	:	M.D.
Telephone Number	:	305-975-4036

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	11/27/2012

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