Organization
FARDALES MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARICELA DIANEXI FARDALES P.A. (OWNER)
(305) 400-9702
Entity
Organization
Contact information
Practice address
8051 W 24TH AVE STE 9, HIALEAH, FL 33016-5596
(305) 400-9702
(305) 397-2165
Mailing address
8051 W 24TH AVE STE 9, HIALEAH, FL 33016-5596
(305) 400-9702
(305) 735-7542
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
PA9103093
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004570500
—
FL
Enumeration date
08/27/2015
Last updated
05/14/2021
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