Provider Demographics
NPI:1235213737
Name:PMN MEDICAL CENTERS, INC
Entity Type:Organization
Organization Name:PMN MEDICAL CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:O
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-553-9669
Mailing Address - Street 1:782 NW 42 AVE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126
Mailing Address - Country:US
Mailing Address - Phone:305-265-7066
Mailing Address - Fax:305-265-3466
Practice Address - Street 1:701 N.W. 57 AVE
Practice Address - Street 2:SUITE 200-240
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126
Practice Address - Country:US
Practice Address - Phone:305-265-0283
Practice Address - Fax:305-675-2788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38850174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4448Medicare PIN
FLK4448Medicare UPIN