Provider Demographics
NPI:1245577592
Name:MEDICAL CENTER OF HOMESTEAD PA
Entity Type:Organization
Organization Name:MEDICAL CENTER OF HOMESTEAD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-255-0098
Mailing Address - Street 1:8750 SW 144TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7296
Mailing Address - Country:US
Mailing Address - Phone:305-255-0098
Mailing Address - Fax:305-255-3466
Practice Address - Street 1:830 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4407
Practice Address - Country:US
Practice Address - Phone:305-255-0098
Practice Address - Fax:305-255-3466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty