Provider Demographics
NPI:1528795499
Name:DISTRICT HEALTH CENTERS LLC
Entity type:Organization
Organization Name:DISTRICT HEALTH CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:ROSARIO DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:305-317-9592
Mailing Address - Street 1:17591 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5435
Mailing Address - Country:US
Mailing Address - Phone:305-317-9592
Mailing Address - Fax:786-431-2577
Practice Address - Street 1:17591 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5435
Practice Address - Country:US
Practice Address - Phone:305-317-9592
Practice Address - Fax:786-431-2577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care