Provider Demographics
NPI:1275551772
Name:HEALTHY START MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:HEALTHY START MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELISEO
Authorized Official - Middle Name:D
Authorized Official - Last Name:ESPAILLAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-403-7388
Mailing Address - Street 1:930 HIALEAH DR
Mailing Address - Street 2:SUITE 7 & 8
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:930 HIALEAH DR
Practice Address - Street 2:SUITE 7 & 8
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5534
Practice Address - Country:US
Practice Address - Phone:305-403-7388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME28418174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8750Medicare ID - Type Unspecified