Provider Demographics
NPI:1477742765
Name:MEDCHOICE OF NORTH HIALEAH, L.L.C.
Entity Type:Organization
Organization Name:MEDCHOICE OF NORTH HIALEAH, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:ACEVEDO, M.D.
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-975-4036
Mailing Address - Street 1:P.O. BOX 141799
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-1799
Mailing Address - Country:US
Mailing Address - Phone:305-557-3889
Mailing Address - Fax:305-557-8830
Practice Address - Street 1:1578 WEST 68 STREET
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:305-557-3889
Practice Address - Fax:305-557-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AV865Medicare PIN