# PROVIDER HEALTH SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164695250
- **Authorized official:** DIANA E PAZ (PRESIDENT)
- **Authorized official phone:** (305) 557-3132

## Contact information

- **Practice address:** 3750 W 16 AVE, SUITE 102, HIALEAH, FL 33012
- **Practice address phone:** (305) 557-3132
- **Practice address fax:** (305) 557-3165
- **Mailing address:** 3750 W 16 AVE, SUITE 102, HIALEAH, FL 33012
- **Mailing address phone:** (305) 557-3132
- **Mailing address fax:** (305) 557-3165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | FL | — |
| 208D00000X | General Practice Physician | — | FL | Yes |

## Other

- **Enumeration date:** 04/09/2008
- **Last updated:** 04/09/2008