Provider Demographics
NPI:1346659828
Name:GLADES MEDICAL CENTERS, L.L.C
Entity Type:Organization
Organization Name:GLADES MEDICAL CENTERS, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOUHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-432-9565
Mailing Address - Street 1:1 N.E. 167TH STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162
Mailing Address - Country:US
Mailing Address - Phone:305-432-9565
Mailing Address - Fax:305-432-9567
Practice Address - Street 1:1 NE 167TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3402
Practice Address - Country:US
Practice Address - Phone:305-432-9565
Practice Address - Fax:305-432-9567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care