Provider Demographics
NPI:1912308719
Name:MIAMI EXCELLENCE MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:MIAMI EXCELLENCE MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-647-2778
Mailing Address - Street 1:8000 NW 7TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4100
Mailing Address - Country:US
Mailing Address - Phone:305-647-2778
Mailing Address - Fax:305-671-9284
Practice Address - Street 1:8000 NW 7TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4100
Practice Address - Country:US
Practice Address - Phone:305-647-2778
Practice Address - Fax:305-671-9284
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIAMI EXCELLENCE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108112174400000X
FLME103151174400000X
FLME117787174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty