Provider Demographics
NPI:1346431426
Name:DIAMOND HEALTH MEDICAL CARE CENTER INC
Entity Type:Organization
Organization Name:DIAMOND HEALTH MEDICAL CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-362-9989
Mailing Address - Street 1:14505 COMMERCE WAY
Mailing Address - Street 2:SUITE 750
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1597
Mailing Address - Country:US
Mailing Address - Phone:305-362-9989
Mailing Address - Fax:305-362-1355
Practice Address - Street 1:14505 COMMERCE WAY
Practice Address - Street 2:SUITE 750
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1597
Practice Address - Country:US
Practice Address - Phone:305-362-9989
Practice Address - Fax:305-362-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty