Provider Demographics
NPI:1730473968
Name:UNIVERSITY HEALTH CARE HIALEAH, INC.
Entity type:Organization
Organization Name:UNIVERSITY HEALTH CARE HIALEAH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-207-4443
Mailing Address - Street 1:8600 NW 17TH ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1039
Mailing Address - Country:US
Mailing Address - Phone:305-207-4443
Mailing Address - Fax:305-207-4442
Practice Address - Street 1:1700 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4437
Practice Address - Country:US
Practice Address - Phone:305-556-6459
Practice Address - Fax:305-556-9623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty