Provider Demographics
NPI:1689617235
Name:AFFILIATED HEALTHCARE PROVIDERS
Entity Type:Organization
Organization Name:AFFILIATED HEALTHCARE PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-826-0244
Mailing Address - Street 1:14101 COMMERCE WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1513
Mailing Address - Country:US
Mailing Address - Phone:305-826-0244
Mailing Address - Fax:
Practice Address - Street 1:14101 COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33016-1513
Practice Address - Country:US
Practice Address - Phone:305-826-0244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP96000069002332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP96000069002OtherCORPORATION NUMBER