Provider Demographics
NPI:1225258106
Name:WEST MEDICAL CENTER HEALTH CARE CORP
Entity Type:Organization
Organization Name:WEST MEDICAL CENTER HEALTH CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUADAGNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-246-2501
Mailing Address - Street 1:7801 SW 133RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3319
Mailing Address - Country:US
Mailing Address - Phone:786-246-2501
Mailing Address - Fax:
Practice Address - Street 1:1665 WEST 68 ST SUITE 208
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:305-558-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6540208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty