Provider Demographics
NPI:1205978517
Name:WEST SERVICES CENTER INC
Entity type:Organization
Organization Name:WEST SERVICES CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARMOLEJOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-220-9272
Mailing Address - Street 1:10511 SW 88TH ST
Mailing Address - Street 2:SUITE E 205
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1535
Mailing Address - Country:US
Mailing Address - Phone:786-220-9272
Mailing Address - Fax:
Practice Address - Street 1:10511 SW 88TH ST
Practice Address - Street 2:SUITE E 205
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1535
Practice Address - Country:US
Practice Address - Phone:786-220-9272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686885Medicare Oscar/Certification