Organization Name: | PALM SPRING MEDICAL CARE OF HIALEAH |
NPI Number: | 1255670592 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARIA C FERNANDEZ (PRESIDENT) |
Mailing Address: | 1140 W 50th St Ste 205 Hialeah |
State: | FL US |
Postal Code: | 330123438 |
Phone Number: | 3053156153 |
Fax Number: | |
NPI Enumeration Date: | 02/06/2013 |
NPI Last Update Date: | 02/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME105031 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |