Provider Demographics
NPI:1295027746
Name:FIRST HEALTH MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:FIRST HEALTH MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-551-7056
Mailing Address - Street 1:9100 SW 24TH ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2076
Mailing Address - Country:US
Mailing Address - Phone:305-551-7056
Mailing Address - Fax:305-551-7058
Practice Address - Street 1:9100 SW 24TH ST
Practice Address - Street 2:SUITE 10
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2076
Practice Address - Country:US
Practice Address - Phone:305-551-7056
Practice Address - Fax:305-551-7058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC9120261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC9120OtherAHCA LICENSE