Provider Demographics
NPI:1497549455
Name:LOVE AND ENERGY MEDICAL CENTER INC
Entity type:Organization
Organization Name:LOVE AND ENERGY MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEYDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANQUERO DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-956-1889
Mailing Address - Street 1:2337 W 76TH ST STE 101-B
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1842
Mailing Address - Country:US
Mailing Address - Phone:786-956-1889
Mailing Address - Fax:305-392-0737
Practice Address - Street 1:4995 NW 72ND AVE STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-5643
Practice Address - Country:US
Practice Address - Phone:786-956-1889
Practice Address - Fax:305-392-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty