Provider Demographics
NPI:1215089529
Name:FENIX CORPORATION
Entity type:Organization
Organization Name:FENIX CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-364-0745
Mailing Address - Street 1:1490 W 49TH PL STE 580B
Mailing Address - Street 2:SUITE 580B
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3190
Mailing Address - Country:US
Mailing Address - Phone:305-364-0745
Mailing Address - Fax:
Practice Address - Street 1:1490 W 49TH PL STE 580B
Practice Address - Street 2:SUITE 580B
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3190
Practice Address - Country:US
Practice Address - Phone:305-364-0745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty