Provider Demographics
NPI:1952902611
Name:TALLON MEDICAL CENTER INC
Entity Type:Organization
Organization Name:TALLON MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:TALLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-388-6308
Mailing Address - Street 1:5600 SW 135TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5125
Mailing Address - Country:US
Mailing Address - Phone:305-388-6308
Mailing Address - Fax:305-388-6309
Practice Address - Street 1:5600 SW 135TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5125
Practice Address - Country:US
Practice Address - Phone:305-388-6308
Practice Address - Fax:305-388-6309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health