Provider Demographics
NPI:1417237322
Name:POWER MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:POWER MEDICAL CENTER, INC.
Other - Org Name:PRIMARY HEALTHCARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:EVELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-512-0464
Mailing Address - Street 1:107 N KROME AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-6016
Mailing Address - Country:US
Mailing Address - Phone:305-247-7765
Mailing Address - Fax:305-247-7796
Practice Address - Street 1:107 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6016
Practice Address - Country:US
Practice Address - Phone:305-247-7765
Practice Address - Fax:305-247-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty