Provider Demographics
NPI:1144827569
Name:TERRANOVA MEDICAL CENTER 1 CORP
Entity type:Organization
Organization Name:TERRANOVA MEDICAL CENTER 1 CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-790-3271
Mailing Address - Street 1:468 NW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3434
Mailing Address - Country:US
Mailing Address - Phone:786-790-3271
Mailing Address - Fax:305-560-5535
Practice Address - Street 1:468 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3434
Practice Address - Country:US
Practice Address - Phone:786-790-3271
Practice Address - Fax:305-560-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care