Provider Demographics
NPI:1134746993
Name:SUPERIOR HEALTH MEDICAL CENTER CORP
Entity type:Organization
Organization Name:SUPERIOR HEALTH MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:YASMIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BORRELL RIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-603-7626
Mailing Address - Street 1:11300 NW 87TH CT STE 120
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4518
Mailing Address - Country:US
Mailing Address - Phone:305-603-7626
Mailing Address - Fax:
Practice Address - Street 1:11300 NW 87TH CT STE 120
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4518
Practice Address - Country:US
Practice Address - Phone:305-603-7626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-28
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health