Provider Demographics
NPI:1669851663
Name:DHM MEDICAL CENTER
Entity Type:Organization
Organization Name:DHM MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINGO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-238-1640
Mailing Address - Street 1:2140 W FLAGLER ST
Mailing Address - Street 2:STE 102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-5600
Mailing Address - Country:US
Mailing Address - Phone:786-238-1640
Mailing Address - Fax:305-504-2737
Practice Address - Street 1:2140 W FLAGLER ST
Practice Address - Street 2:STE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-5600
Practice Address - Country:US
Practice Address - Phone:786-238-1640
Practice Address - Fax:305-504-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service