Provider Demographics
NPI:1720107287
Name:LA SCALA MEDICAL CENTER INC
Entity Type:Organization
Organization Name:LA SCALA MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUSTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-485-9847
Mailing Address - Street 1:8360 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3354
Mailing Address - Country:US
Mailing Address - Phone:305-485-9847
Mailing Address - Fax:305-485-9850
Practice Address - Street 1:8360 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3354
Practice Address - Country:US
Practice Address - Phone:305-485-9847
Practice Address - Fax:305-485-9850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty