Provider Demographics
NPI:1104082833
Name:HISPANIC HEALTHCARE CENTER INC
Entity type:Organization
Organization Name:HISPANIC HEALTHCARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-642-7474
Mailing Address - Street 1:9131 SW 8TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3155
Mailing Address - Country:US
Mailing Address - Phone:305-642-7474
Mailing Address - Fax:305-642-7475
Practice Address - Street 1:1774 SW 8TH ST STE A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3507
Practice Address - Country:US
Practice Address - Phone:786-837-4110
Practice Address - Fax:305-642-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL98585208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL98585OtherME