Organization
PALM MEDICAL WEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SANTIAGO MOISES (DIRECTOR OF CENTERS OPERATIONS)
(786) 362-4173
Entity
Organization
Contact information
Practice address
1840 WEST 49 STREET, SUITE: 100, HIALEAH, FL 33012
(305) 913-7300
Mailing address
1840 W 49TH ST, SUITE 100, HIALEAH, FL 33012-2942
(305) 913-7300
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2014
Last updated
03/21/2014
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