Provider Demographics
NPI:1790292464
Name:ACCIDENT911HELP MEDICAL CENTER, CORP
Entity Type:Organization
Organization Name:ACCIDENT911HELP MEDICAL CENTER, CORP
Other - Org Name:N/A
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:ARIAS
Authorized Official - Suffix:X
Authorized Official - Credentials:OWNER
Authorized Official - Phone:786-873-1426
Mailing Address - Street 1:2387 W 68TH ST STE 303
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6890
Mailing Address - Country:US
Mailing Address - Phone:786-873-1426
Mailing Address - Fax:786-502-8628
Practice Address - Street 1:2387 W 68TH ST STE 303
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-6890
Practice Address - Country:US
Practice Address - Phone:786-873-1426
Practice Address - Fax:786-502-8628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherHEALTHCARE CLINIC