Organization
IDEAL MEDICAL CENTER OF HIALEAH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OCTAVIO ALEXIS BRAVO (COO)
(305) 557-2277
Entity
Organization
Contact information
Practice address
3805 W 20 AVE SUITE 105, HIALEAH, FL 33012
(305) 557-2277
Mailing address
11782 SW 92 TER, MIAMI, FL 33186
(305) 271-7464
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
HCC6717
FL
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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