Provider Demographics
NPI:1508103680
Name:HILLSTONE MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:HILLSTONE MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCISCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-299-8077
Mailing Address - Street 1:7171 CORAL WAY
Mailing Address - Street 2:STE 316
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1449
Mailing Address - Country:US
Mailing Address - Phone:786-999-6488
Mailing Address - Fax:
Practice Address - Street 1:7171 CORAL WAY
Practice Address - Street 2:STE 316
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1449
Practice Address - Country:US
Practice Address - Phone:786-999-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM27457261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center