# FOUR FORTY WEST MEDICAL & SURGICAL CENTER CORP

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

## Provider details

- **NPI number:** 1427159193
- **Authorized official:** CARLOS ROIG PA (PRESIDENT)
- **Authorized official phone:** (305) 556-7706

## Contact information

- **Practice address:** 440 W 65TH ST, HIALEAH, FL 33012-6640
- **Practice address phone:** (305) 556-7706
- **Practice address fax:** (305) 557-7296
- **Mailing address:** 440 W 65TH ST, HIALEAH, FL 33012-6640
- **Mailing address phone:** (305) 556-7706
- **Mailing address fax:** (305) 557-7296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | HCC4055 AHCA LIC | FL | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 08/22/2020