Organization
AVALON MEDICAL CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUSTAVO BOLANOS (PRESIDENT)
(305) 821-3155
Entity
Organization
Contact information
Practice address
6065 NW 167TH ST, SUITE B-7, HIALEAH, FL 33015-4327
(305) 821-3155
(305) 821-3166
Mailing address
6065 NW 167TH ST, SUITE B-7, HIALEAH, FL 33015-4327
(305) 821-3155
(305) 821-3166
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC8681
FL
Other
Enumeration date
03/01/2010
Last updated
03/01/2010
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