Organization
DE LA VEGA MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE R PEREZ (MANAGER)
(786) 600-4040
Entity
Organization
Contact information
Practice address
11093 NW 138 STREET, SUITE 121, HIALEAH GARDENS, FL 33018
(786) 600-4040
(786) 953-5174
Mailing address
11093 NW 138 STREET, SUITE 121, HIALEAH GARDENS, FL 33018
(786) 953-5174
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2017
Last updated
08/31/2018
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