Provider Demographics
NPI:1124450077
Name:HISPANIC HEALTH ENTERPRISES LLC
Entity type:Organization
Organization Name:HISPANIC HEALTH ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TABARE
Authorized Official - Middle Name:D
Authorized Official - Last Name:TABAR
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:239-331-9610
Mailing Address - Street 1:4990 GOLDEN GATE PKWY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-6962
Mailing Address - Country:US
Mailing Address - Phone:239-692-8309
Mailing Address - Fax:239-692-8504
Practice Address - Street 1:4990 GOLDEN GATE PKWY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-6962
Practice Address - Country:US
Practice Address - Phone:239-692-8309
Practice Address - Fax:239-692-8504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty