Provider Demographics
NPI:1588607378
Name:HUMANITY HEALTH MEDICAL CENTER,INC
Entity Type:Organization
Organization Name:HUMANITY HEALTH MEDICAL CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:DE XIMENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-982-8763
Mailing Address - Street 1:8660 WEST FLAGLER STREET
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144
Mailing Address - Country:US
Mailing Address - Phone:305-982-8763
Mailing Address - Fax:786-362-6738
Practice Address - Street 1:8660 WEST FLAGLER STREET
Practice Address - Street 2:SUITE 105
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144
Practice Address - Country:US
Practice Address - Phone:305-982-8763
Practice Address - Fax:786-362-6738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5865261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7215Medicare PIN