Provider Demographics
NPI:1912158718
Name:BETHEL ASSOCIATED COMERCIAL CLEANING, INC.
Entity Type:Organization
Organization Name:BETHEL ASSOCIATED COMERCIAL CLEANING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-523-5090
Mailing Address - Street 1:5901 NW 151ST ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2452
Mailing Address - Country:US
Mailing Address - Phone:786-523-5090
Mailing Address - Fax:
Practice Address - Street 1:5901 NW 151ST ST
Practice Address - Street 2:SUITE 207
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-2452
Practice Address - Country:US
Practice Address - Phone:786-523-5090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization