Provider Demographics
NPI:1467786814
Name:ROSELL HERNANDEZ MEDICAL CENTER
Entity Type:Organization
Organization Name:ROSELL HERNANDEZ MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUSSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-400-8114
Mailing Address - Street 1:2455 SW 27TH AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3663
Mailing Address - Country:US
Mailing Address - Phone:305-400-8114
Mailing Address - Fax:305-400-8246
Practice Address - Street 1:2455 SW 27TH AVE
Practice Address - Street 2:STE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3663
Practice Address - Country:US
Practice Address - Phone:305-400-8114
Practice Address - Fax:305-400-8246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty