Provider Demographics
NPI:1710576988
Name:ESTRELLA HEALTH MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ESTRELLA HEALTH MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARINE
Authorized Official - Middle Name:V
Authorized Official - Last Name:VIAMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-246-6295
Mailing Address - Street 1:10250 SW 56TH ST STE D201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7098
Mailing Address - Country:US
Mailing Address - Phone:305-778-1485
Mailing Address - Fax:786-362-5735
Practice Address - Street 1:10250 SW 56TH ST STE D201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7098
Practice Address - Country:US
Practice Address - Phone:305-778-1485
Practice Address - Fax:786-362-5735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty