Provider Demographics
NPI:1487014890
Name:PINEL MEDICAL CENTER
Entity Type:Organization
Organization Name:PINEL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CADET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-753-6600
Mailing Address - Street 1:620 NE 128TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4829
Mailing Address - Country:US
Mailing Address - Phone:305-893-8080
Mailing Address - Fax:786-235-7778
Practice Address - Street 1:620 NE 128TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4829
Practice Address - Country:US
Practice Address - Phone:305-893-8080
Practice Address - Fax:786-235-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27293305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037315000Medicaid
FL037315000Medicaid
FL92970Medicare PIN