Provider Demographics
NPI:1861548661
Name:BARNETT MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:BARNETT MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:R-RAY TECHNICIAN
Authorized Official - Phone:305-649-1911
Mailing Address - Street 1:110 NW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-5114
Mailing Address - Country:US
Mailing Address - Phone:305-649-1011
Mailing Address - Fax:305-649-8840
Practice Address - Street 1:110 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5114
Practice Address - Country:US
Practice Address - Phone:305-649-1011
Practice Address - Fax:305-649-8840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4050261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99140Medicare UPIN
FLE31255Medicare UPIN
FLD59900Medicare UPIN