Provider Demographics
NPI:1366864308
Name:ACN CEIVA MEDICAL CENTER
Entity Type:Organization
Organization Name:ACN CEIVA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEIVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-483-7723
Mailing Address - Street 1:7500 SW 8 ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144
Mailing Address - Country:US
Mailing Address - Phone:786-483-7723
Mailing Address - Fax:786-431-5786
Practice Address - Street 1:7500 SW 8 ST
Practice Address - Street 2:SUITE 303
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144
Practice Address - Country:US
Practice Address - Phone:786-483-7723
Practice Address - Fax:786-431-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN366261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center