Provider Demographics
NPI:1629662689
Name:S & S MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:S & S MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-291-7838
Mailing Address - Street 1:5918 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2604
Mailing Address - Country:US
Mailing Address - Phone:786-291-7838
Mailing Address - Fax:
Practice Address - Street 1:5918 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2604
Practice Address - Country:US
Practice Address - Phone:786-291-7838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health