Provider Demographics
NPI:1730690124
Name:RELIABLE ALLIANCE HEALTHCARE
Entity type:Organization
Organization Name:RELIABLE ALLIANCE HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YANET
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:305-223-0570
Mailing Address - Street 1:9380 SUNSET DR STE B245
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5466
Mailing Address - Country:US
Mailing Address - Phone:305-223-0570
Mailing Address - Fax:305-223-0580
Practice Address - Street 1:9380 SUNSET DR STE B245
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5466
Practice Address - Country:US
Practice Address - Phone:305-223-0570
Practice Address - Fax:305-223-0580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RELIABLE ALLIANCE HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-12
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
FLOS9645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110574000Medicaid
FL607833OtherSTATE FLORIDA LICENSE
FL104811700Medicaid