MEDICARE: E&M HEALTHCARE SERVICES LLC

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	261QD1600X	Developmental Disabilities Clinic/Center

General Provider Information

NPI Number	:	1922841899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E&M HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	4450 W 16TH AVE APT 222
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7107
Country	:	US
Telephone Number	:	786-858-6324
Fax Number	:

Provider Business Practice Location Address
First Line	:	4450 W 16TH AVE APT 222
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-7107
Country	:	US
Telephone Number	:	786-858-6324
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MARIA HERNANDEZ
Credential	:
Telephone Number	:	786-858-6324

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	06/20/2024

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