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Organization
LEGACY MEDICAL CENTER LLC
Active
Organization
LEGACY MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFREDO CUBA (CEO)
(786) 263-3100
Entity
Organization
Contact information
Practice address
6741 SW 24TH ST STE 46, MIAMI, FL 33155-1767
(786) 427-7059
Mailing address
6741 SW 24TH ST STE 46, MIAMI, FL 33155-1767
(786) 427-7059
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101681100
—
FL
Enumeration date
04/02/2021
Last updated
05/18/2022
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