Provider Demographics
NPI:1528287083
Name:MONES ALHAMBRA FAMILY PRACTICE CENTER PA
Entity type:Organization
Organization Name:MONES ALHAMBRA FAMILY PRACTICE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:MONES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-448-8134
Mailing Address - Street 1:2645 SW 37TH AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2754
Mailing Address - Country:US
Mailing Address - Phone:305-448-8134
Mailing Address - Fax:305-445-2691
Practice Address - Street 1:2645 SW 37TH AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2754
Practice Address - Country:US
Practice Address - Phone:305-448-8134
Practice Address - Fax:305-445-2691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5931283208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD27362Medicare UPIN