Provider Demographics
NPI:1396045696
Name:SOCORRO'S MEDICAL CENTER CORP.
Entity Type:Organization
Organization Name:SOCORRO'S MEDICAL CENTER CORP.
Other - Org Name:FLORIDA HEALTH SOLUTION CENTER, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRES./ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:P
Authorized Official - Last Name:SOCORRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-269-2004
Mailing Address - Street 1:7350 NW 7 ST SUITE 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2932
Mailing Address - Country:US
Mailing Address - Phone:305-269-2004
Mailing Address - Fax:305-269-2080
Practice Address - Street 1:1779 W 37TH ST UNIT 1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4667
Practice Address - Country:US
Practice Address - Phone:305-823-3171
Practice Address - Fax:305-384-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
FL261QM1300X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty