Provider Demographics
NPI:1114633237
Name:LA FAMILIA MEDICAL CENTER II HIALEAH CORP.
Entity Type:Organization
Organization Name:LA FAMILIA MEDICAL CENTER II HIALEAH CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LEONARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-303-7796
Mailing Address - Street 1:3824 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4127
Mailing Address - Country:US
Mailing Address - Phone:786-547-5527
Mailing Address - Fax:
Practice Address - Street 1:3824 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4127
Practice Address - Country:US
Practice Address - Phone:786-547-5527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center