Provider Demographics
NPI:1184679755
Name:MITTO HEALTH CENTER
Entity Type:Organization
Organization Name:MITTO HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OTTO
Authorized Official - Middle Name:
Authorized Official - Last Name:HEVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-325-1826
Mailing Address - Street 1:8115 SW 147TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1553
Mailing Address - Country:US
Mailing Address - Phone:786-325-1826
Mailing Address - Fax:
Practice Address - Street 1:1271 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4719
Practice Address - Country:US
Practice Address - Phone:305-324-7827
Practice Address - Fax:305-324-7829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty