Organization
NINOJESUS MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS DIAZ VALLADARES APRN (OWNER)
(305) 456-4096
Entity
Organization
Contact information
Practice address
7600 W 20TH AVE STE 101, HIALEAH, FL 33016-1895
(305) 456-4096
(786) 828-7995
Mailing address
16400 SW 173RD AVE, MIAMI, FL 33187-1251
(305) 456-4096
(786) 828-7995
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/28/2025
Last updated
01/29/2026
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