Provider Demographics
NPI:1972295780
Name:HERO ELITE MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:HERO ELITE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-351-4493
Mailing Address - Street 1:6447 MIAMI LAKES DR STE 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2765
Mailing Address - Country:US
Mailing Address - Phone:786-351-4493
Mailing Address - Fax:
Practice Address - Street 1:6447 MIAMI LAKES DR STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2765
Practice Address - Country:US
Practice Address - Phone:786-351-4493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty