Provider Demographics
NPI:1184902199
Name:ALPHA HEALTH MEDICAL CENTER INC
Entity type:Organization
Organization Name:ALPHA HEALTH MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-225-5510
Mailing Address - Street 1:8360 W FLAGLER ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2042
Mailing Address - Country:US
Mailing Address - Phone:305-225-5510
Mailing Address - Fax:305-225-5535
Practice Address - Street 1:8360 W FLAGLER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2042
Practice Address - Country:US
Practice Address - Phone:305-225-5510
Practice Address - Fax:305-225-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 63940261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy