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4578 W 12th Ave Hialeah FL 33012-3325 | |
| (305) 828-1989 | |
| (305) 828-2775 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 4578 W 12th Ave, Hialeah, Florida |
| Authorized Official Name and Position | Jorge Raad (OWNER/PRESIDENT) |
| Authorized Official Contact | 7862336981 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6355 Sw 36 Ave East Building Ste 1100 Virginia Gardens FL 33166 Ph: (786) 233-6981 | 4578 W 12th Ave Hialeah FL 33012-3325 Ph: (305) 828-1989 |
| NPI Number | 1477374890 |
|---|---|
| Provider Enumeration Date | 10/18/2024 |
| Last Update Date | 11/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477374890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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