Provider Demographics
NPI:1467928432
Name:PAIN RELIEF CENTER OF HIALEAH LLC
Entity Type:Organization
Organization Name:PAIN RELIEF CENTER OF HIALEAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MINSU DE LA CARIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-639-8772
Mailing Address - Street 1:1140 W 50TH ST STE 307A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3411
Mailing Address - Country:US
Mailing Address - Phone:305-639-8772
Mailing Address - Fax:
Practice Address - Street 1:1140 W 50TH ST STE 307A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3411
Practice Address - Country:US
Practice Address - Phone:305-639-8772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center