Provider Demographics
NPI:1083461891
Name:HEALTHMED CLINICAL CENTER INC
Entity type:Organization
Organization Name:HEALTHMED CLINICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JESDIT
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-786-0658
Mailing Address - Street 1:3971 SW 8TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2950
Mailing Address - Country:US
Mailing Address - Phone:786-786-0658
Mailing Address - Fax:786-786-0904
Practice Address - Street 1:3971 SW 8TH ST STE 209
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2950
Practice Address - Country:US
Practice Address - Phone:786-786-0658
Practice Address - Fax:786-786-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty