Provider Demographics
NPI:1720555204
Name:POPULATION HEALTH ALLIANCE LLC
Entity Type:Organization
Organization Name:POPULATION HEALTH ALLIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARUNCHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-878-5505
Mailing Address - Street 1:806 S DOUGLAS RD STE 700
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2082
Mailing Address - Country:US
Mailing Address - Phone:786-878-5500
Mailing Address - Fax:786-552-9696
Practice Address - Street 1:8200 SW 117TH AVE STE 314
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4826
Practice Address - Country:US
Practice Address - Phone:305-274-6422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Yes305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Single Specialty