Provider Demographics
NPI:1417195926
Name:SERENE MEDICAL CENTER OF HIALEAH, INC.
Entity Type:Organization
Organization Name:SERENE MEDICAL CENTER OF HIALEAH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:URBINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-885-8722
Mailing Address - Street 1:4501 PALM AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4010
Mailing Address - Country:US
Mailing Address - Phone:305-885-8722
Mailing Address - Fax:305-885-5346
Practice Address - Street 1:4501 PALM AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4010
Practice Address - Country:US
Practice Address - Phone:305-885-8722
Practice Address - Fax:305-885-5346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6072261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center