Provider Demographics
NPI:1609377035
Name:CH MEDICAL GROUP CORP.
Entity Type:Organization
Organization Name:CH MEDICAL GROUP CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:DEL CARMEN
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:305-643-4797
Mailing Address - Street 1:711 NW 23RD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3395
Mailing Address - Country:US
Mailing Address - Phone:305-643-4797
Mailing Address - Fax:305-643-4880
Practice Address - Street 1:711 NW 23RD AVE STE 301
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3395
Practice Address - Country:US
Practice Address - Phone:305-643-4797
Practice Address - Fax:305-643-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-21
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty