# EXCELSIOR MEDICAL HEALTH CENTER LLC

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

## Provider details

- **NPI number:** 1710485255
- **Authorized official:** MRS. GERALDA PHANOR FLEURANVIL PA-C (CEO)
- **Authorized official phone:** (786) 564-9438

## Contact information

- **Practice address:** 18441 NW 2ND AVE STE 103, MIAMI GARDENS, FL 33169-4517
- **Practice address phone:** (305) 650-1158
- **Mailing address:** 1441 NW 204TH ST, MIAMI, FL 33169-2452
- **Mailing address phone:** (786) 564-9438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | PA9104039 | FL | — |

## Other

- **Enumeration date:** 01/30/2018
- **Last updated:** 11/09/2021