Organization
INTERSTATE MEDICAL CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSVALDO FERNANDEZ (PRESIDENT)
(516) 737-8420
Entity
Organization
Contact information
Practice address
4228 W 16TH AVE, HIALEAH, FL 33012-7624
(516) 737-8420
Mailing address
4228 W 16TH AVE, HIALEAH, FL 33012-7624
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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