Provider Demographics
NPI:1629329859
Name:LA ALIANZA MEDICAL CENTER 1, LLC.
Entity Type:Organization
Organization Name:LA ALIANZA MEDICAL CENTER 1, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:CARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-505-4544
Mailing Address - Street 1:8512 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4053
Mailing Address - Country:US
Mailing Address - Phone:305-505-4544
Mailing Address - Fax:305-505-4544
Practice Address - Street 1:8512 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4053
Practice Address - Country:US
Practice Address - Phone:305-505-4544
Practice Address - Fax:305-505-4544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC0000261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center