Provider Demographics
NPI:1235011933
Name:SELEM MEDICAL CENTER CORP
Entity type:Organization
Organization Name:SELEM MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:XIOMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-448-7848
Mailing Address - Street 1:4800 W FLAGLER ST STE 106
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1400
Mailing Address - Country:US
Mailing Address - Phone:305-448-7848
Mailing Address - Fax:305-446-9661
Practice Address - Street 1:4800 W FLAGLER ST STE 106
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1400
Practice Address - Country:US
Practice Address - Phone:305-448-7848
Practice Address - Fax:305-446-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106028300Medicaid