Provider Demographics
NPI:1891093951
Name:HET MEDICAL INC
Entity Type:Organization
Organization Name:HET MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYRE
Authorized Official - Middle Name:
Authorized Official - Last Name:URDANETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-828-8290
Mailing Address - Street 1:5801 NW 151ST ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2437
Mailing Address - Country:US
Mailing Address - Phone:305-828-8290
Mailing Address - Fax:305-828-8291
Practice Address - Street 1:5801 NW 151ST ST
Practice Address - Street 2:SUITE 107
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2437
Practice Address - Country:US
Practice Address - Phone:305-828-8290
Practice Address - Fax:305-828-8291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73691208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty