Provider Demographics
NPI:1598717142
Name:HEALTH TRUST MEDICAL CARE
Entity Type:Organization
Organization Name:HEALTH TRUST MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARNALDO
Authorized Official - Middle Name:M
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-891-7960
Mailing Address - Street 1:11601 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3151
Mailing Address - Country:US
Mailing Address - Phone:305-891-7960
Mailing Address - Fax:305-891-7943
Practice Address - Street 1:11601 BISCAYNE BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3151
Practice Address - Country:US
Practice Address - Phone:305-891-7960
Practice Address - Fax:305-891-7943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6623261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
K8193Medicare ID - Type Unspecified