MEDICARE: TU CLINICA HISPANA

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1487445623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TU CLINICA HISPANA

Provider Business Mailing Address
First Line	:	12 PALM PLZ
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33030-6046
Country	:	US
Telephone Number	:	786-504-2472
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 PALM PLZ
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33030-6046
Country	:	US
Telephone Number	:	786-504-2472
Fax Number	:	786-504-8080

Authorized Official
Title or Position	:	CEO
Name	:	KARINA CEDENO
Credential	:
Telephone Number	:	469-996-5502

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	05/15/2025

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Directions to “TU CLINICA HISPANA ” Practice Location

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