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Organization
WEST 49TH STREET E.R. PHYSICIAN CORP.
Active
Organization
WEST 49TH STREET E.R. PHYSICIAN CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK EARLY (CHIEF FINANCIAL OFFICER)
(305) 824-4703
Entity
Organization
Contact information
Practice address
1475 W 49TH ST, HIALEAH, FL 33012-3222
(305) 558-2500
(305) 826-9002
Mailing address
1475 W 49TH ST, HIALEAH, FL 33012-3222
(305) 558-2500
(305) 826-9002
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
282N00000X
General Acute Care Hospital
—
NULL
Other
Enumeration date
04/02/2007
Last updated
10/29/2012
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