Provider Demographics
NPI:1790355089
Name:DELUXE HEALTH CENTER LLC
Entity Type:Organization
Organization Name:DELUXE HEALTH CENTER LLC
Other - Org Name:DELUXE HEALTH CENTER LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIMENTEL
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:305-951-6392
Mailing Address - Street 1:5795 NW 151ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2479
Mailing Address - Country:US
Mailing Address - Phone:305-951-6392
Mailing Address - Fax:
Practice Address - Street 1:5795 NW 151ST ST STE B
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2479
Practice Address - Country:US
Practice Address - Phone:305-951-6392
Practice Address - Fax:786-615-2359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty