Provider Demographics
NPI:1346294949
Name:ATHENNAS MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:ATHENNAS MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAHIMY
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-493-4659
Mailing Address - Street 1:633 NE 167TH ST
Mailing Address - Street 2:SUITE 1111
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-2442
Mailing Address - Country:US
Mailing Address - Phone:305-493-4659
Mailing Address - Fax:305-493-4660
Practice Address - Street 1:633 NE 167TH ST
Practice Address - Street 2:SUITE 1111
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2442
Practice Address - Country:US
Practice Address - Phone:305-493-4659
Practice Address - Fax:305-493-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty