Provider Demographics
NPI:1134136724
Name:PS MEDICAL CENTER
Entity Type:Organization
Organization Name:PS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SERIAL BIONDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-260-2511
Mailing Address - Street 1:12991 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4809
Mailing Address - Country:US
Mailing Address - Phone:305-892-3383
Mailing Address - Fax:
Practice Address - Street 1:12991 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4809
Practice Address - Country:US
Practice Address - Phone:305-892-3383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC 7280208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty