Provider Demographics
NPI:1366655425
Name:PHYSICIANS HEALTHCARE NETWORK, INC
Entity Type:Organization
Organization Name:PHYSICIANS HEALTHCARE NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIRANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-898-7065
Mailing Address - Street 1:PO BOX 144176
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-4176
Mailing Address - Country:US
Mailing Address - Phone:305-898-7065
Mailing Address - Fax:
Practice Address - Street 1:7105 SW 8TH ST
Practice Address - Street 2:SUITE 409
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4664
Practice Address - Country:US
Practice Address - Phone:305-898-7065
Practice Address - Fax:305-898-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24329OtherCAREPLUS HEALTH PLANS
FL5207OtherTOTAL HEALTH CHOICE