Provider Demographics
NPI:1235828567
Name:GARDENS MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:GARDENS MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-450-9918
Mailing Address - Street 1:12963 W OKEECHOBEE RD
Mailing Address - Street 2:UNIT 3
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6055
Mailing Address - Country:US
Mailing Address - Phone:786-450-9918
Mailing Address - Fax:
Practice Address - Street 1:12963 W OKEECHOBEE RD
Practice Address - Street 2:UNIT 3
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-6055
Practice Address - Country:US
Practice Address - Phone:786-450-9918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty