Provider Demographics
NPI:1316685035
Name:MORENO MEDICAL CENTER LLC
Entity type:Organization
Organization Name:MORENO MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:I
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-364-5533
Mailing Address - Street 1:85 GRAND CANAL DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2570
Mailing Address - Country:US
Mailing Address - Phone:305-364-5533
Mailing Address - Fax:305-364-5398
Practice Address - Street 1:85 GRAND CANAL DR STE 400
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2570
Practice Address - Country:US
Practice Address - Phone:305-364-5533
Practice Address - Fax:305-364-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center