Provider Demographics
NPI:1750739397
Name:FAMILY QUALITY HEALTH
Entity type:Organization
Organization Name:FAMILY QUALITY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-773-3590
Mailing Address - Street 1:5881 NW 151ST ST
Mailing Address - Street 2:SUIT 211
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2450
Mailing Address - Country:US
Mailing Address - Phone:786-773-3590
Mailing Address - Fax:786-773-3593
Practice Address - Street 1:5881 NW 151ST ST
Practice Address - Street 2:SUIT 211
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2450
Practice Address - Country:US
Practice Address - Phone:786-773-3590
Practice Address - Fax:786-773-3593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10667208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty