Provider Demographics
NPI:1154209344
Name:GLS PROHEALTH MEDICAL CENTER INC
Entity type:Organization
Organization Name:GLS PROHEALTH MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:ATILIO
Authorized Official - Last Name:PINELO
Authorized Official - Suffix:
Authorized Official - Credentials:ACN
Authorized Official - Phone:786-417-9485
Mailing Address - Street 1:11825 SW 104TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-3958
Mailing Address - Country:US
Mailing Address - Phone:786-417-9485
Mailing Address - Fax:
Practice Address - Street 1:9600 SW 8TH ST STE 25
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2968
Practice Address - Country:US
Practice Address - Phone:786-417-9485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty