Provider Demographics
NPI:1366137101
Name:PENATE MEDICAL CENTER 7 LLC
Entity type:Organization
Organization Name:PENATE MEDICAL CENTER 7 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-272-9170
Mailing Address - Street 1:8200 SW 117TH AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6565 TAFT ST STE 100
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-4000
Practice Address - Country:US
Practice Address - Phone:954-331-4966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center