Provider Demographics
NPI:1952670317
Name:GOOD HANDS MEDICAL CENTER
Entity Type:Organization
Organization Name:GOOD HANDS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAYLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:305-815-9293
Mailing Address - Street 1:4155 SW 130TH AVE
Mailing Address - Street 2:205
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3414
Mailing Address - Country:US
Mailing Address - Phone:305-815-9293
Mailing Address - Fax:
Practice Address - Street 1:4155 SW 130TH AVE
Practice Address - Street 2:205
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3414
Practice Address - Country:US
Practice Address - Phone:305-815-9293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49444273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA49444OtherSTATE LICENSE