Provider Demographics
NPI:1306191671
Name:DADE COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:DADE COUNTY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-431-5876
Mailing Address - Street 1:2360 W 68TH ST
Mailing Address - Street 2:# 129
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5514
Mailing Address - Country:US
Mailing Address - Phone:786-431-5876
Mailing Address - Fax:786-431-5704
Practice Address - Street 1:2360 W 68TH ST
Practice Address - Street 2:# 129
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5514
Practice Address - Country:US
Practice Address - Phone:786-431-5876
Practice Address - Fax:786-431-5704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service