Provider Demographics
NPI:1710298971
Name:FELICIDAD MEDICAL CENTER INC
Entity Type:Organization
Organization Name:FELICIDAD MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:ORLANDO
Authorized Official - Last Name:SOLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-824-8559
Mailing Address - Street 1:4410 W 16TH AVE
Mailing Address - Street 2:SUITE 55
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:305-824-8559
Mailing Address - Fax:305-824-8561
Practice Address - Street 1:4410 W 16TH AVE
Practice Address - Street 2:SUITE 55
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012
Practice Address - Country:US
Practice Address - Phone:305-824-8559
Practice Address - Fax:305-824-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251S00000X, 261QM0801X, 261QM0850X, 261QU0200X
FLHC8779261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011828000Medicaid