Provider Demographics
NPI:1063201234
Name:GESA MEDICAL CENTER CORP.
Entity type:Organization
Organization Name:GESA MEDICAL CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-836-9014
Mailing Address - Street 1:2204 SW 106TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7945
Mailing Address - Country:US
Mailing Address - Phone:786-836-9014
Mailing Address - Fax:
Practice Address - Street 1:3850 SW 87TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5474
Practice Address - Country:US
Practice Address - Phone:305-845-7787
Practice Address - Fax:786-936-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty