Provider Demographics
NPI:1780873380
Name:HEALING MEDICAL CENTER INC
Entity type:Organization
Organization Name:HEALING MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEBNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-823-4002
Mailing Address - Street 1:5931 NW 173RD DR
Mailing Address - Street 2:UNIT-7A
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5106
Mailing Address - Country:US
Mailing Address - Phone:305-823-4002
Mailing Address - Fax:
Practice Address - Street 1:5931 NW 173RD DR
Practice Address - Street 2:UNIT-7A
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5106
Practice Address - Country:US
Practice Address - Phone:305-823-4002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
FLHCC8057261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)