Provider Demographics
NPI:1467019273
Name:LOVELY MEDICAL CENTER INC
Entity type:Organization
Organization Name:LOVELY MEDICAL CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EUGENIO
Authorized Official - Middle Name:ALXIDEZ
Authorized Official - Last Name:HERNANDE
Authorized Official - Suffix:
Authorized Official - Credentials:ME
Authorized Official - Phone:305-530-8096
Mailing Address - Street 1:7235 SW 24TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1452
Mailing Address - Country:US
Mailing Address - Phone:305-530-8096
Mailing Address - Fax:
Practice Address - Street 1:7235 CORAL WAY STE 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1452
Practice Address - Country:US
Practice Address - Phone:305-530-8096
Practice Address - Fax:786-409-6272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy