Provider Demographics
NPI:1376204420
Name:AMEDICAL LUXURY
Entity Type:Organization
Organization Name:AMEDICAL LUXURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:PRECIADO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:786-362-4338
Mailing Address - Street 1:117 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2235
Mailing Address - Country:US
Mailing Address - Phone:786-407-4103
Mailing Address - Fax:
Practice Address - Street 1:117 E 41ST ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-2235
Practice Address - Country:US
Practice Address - Phone:786-407-4103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service