Provider Demographics
NPI:1275736548
Name:WEST MIAMI HEALTH CENTER CORP
Entity Type:Organization
Organization Name:WEST MIAMI HEALTH CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ-ESTEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-338-9243
Mailing Address - Street 1:1425 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1234
Mailing Address - Country:US
Mailing Address - Phone:786-338-9243
Mailing Address - Fax:783-264-1383
Practice Address - Street 1:1425 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-1234
Practice Address - Country:US
Practice Address - Phone:786-338-9243
Practice Address - Fax:786-264-1383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty