Organization
PALM MEDICAL CENTER LITTLE HAVANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLEN MORALES JD (COMPLIANCE OFFICER)
(305) 913-9447
Entity
Organization
Contact information
Practice address
2501 SW 8TH ST, MIAMI, FL 33135-3005
(305) 642-9992
(305) 442-1198
Mailing address
2600 S DOUGLAS RD STE 308, CORAL GABLES, FL 33134-6134
(305) 913-9447
(305) 442-1198
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC11110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC11110
AGENCY FOR HEALTH CARE ADMINISTRATION LICENSE NUMBER
FL
Enumeration date
08/15/2017
Last updated
06/16/2018
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