Provider Demographics
NPI:1154348811
Name:NEW GENERATION MEDICAL CENTER INC
Entity type:Organization
Organization Name:NEW GENERATION MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:HUERRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-545-8913
Mailing Address - Street 1:326 SW 12TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2012
Mailing Address - Country:US
Mailing Address - Phone:305-545-8913
Mailing Address - Fax:305-642-7733
Practice Address - Street 1:326 SW 12TH AVE STE A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2012
Practice Address - Country:US
Practice Address - Phone:305-545-8913
Practice Address - Fax:305-642-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109321800Medicaid