Organization
POWER G MEDICAL CENTER, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OSVALDO AVILA (PRESIDENT)
(305) 822-9108
Entity
Organization
Contact information
Practice address
14160 PALMETTO FRONTAGE RD, SUITE 100, MIAMI LAKES, FL 33016
(305) 822-9108
(305) 822-9028
Mailing address
14160 PALMETTO FRONTAGE RD, SUITE 100, MIAMI LAKES, FL 33016
(305) 822-9108
(305) 822-9028
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC9429
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FILE 10006
AHCA HCC UNIT
FL
Enumeration date
01/31/2012
Last updated
01/19/2016
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