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Organization
WK MEDICAL CENTER CORP
Active
Organization
WK MEDICAL CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDEL QUINTERO (PRESIDENT)
(305) 424-9060
Entity
Organization
Contact information
Practice address
13304 SW 128TH ST, MIAMI, FL 33186-5899
(054) 249-0603
(305) 363-4412
Mailing address
13304 SW 128TH ST, MIAMI, FL 33186-5899
(786) 227-6498
(305) 570-2604
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
FL
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC11075
AHCA
FL
Enumeration date
07/11/2017
Last updated
03/19/2024
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