Provider Demographics
NPI:1972784106
Name:ATENA MEDICAL CENTER
Entity Type:Organization
Organization Name:ATENA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V P
Authorized Official - Prefix:MR
Authorized Official - First Name:ORENCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-305-7830
Mailing Address - Street 1:3990 W FLAGLER STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-305-7830
Mailing Address - Fax:
Practice Address - Street 1:3990 W FLAGLER STREET SUITE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-305-7830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty