Provider Demographics
NPI:1578179404
Name:BUENA VISTA MEDICAL CENTER INC
Entity Type:Organization
Organization Name:BUENA VISTA MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:RICHAR
Authorized Official - Last Name:ALMAGUER GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-715-8937
Mailing Address - Street 1:14505 COMMERCE WAY STE 509
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1529
Mailing Address - Country:US
Mailing Address - Phone:786-715-8937
Mailing Address - Fax:
Practice Address - Street 1:14505 COMMERCE WAY STE 509
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1529
Practice Address - Country:US
Practice Address - Phone:786-715-8937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)