Evelyn Medical Center Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

HCC5602 Issued in FL

Legal business name

EVELYN MEDICAL CENTER INC

Practice address

1840 W 49TH St
Suite 227
Hialeah, FL 33012-2942

Phone

(305) 820-0095

Fax

(305) 820-0095

NPI assigned

Mar 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ernesto M Carralero

Title

President

Phone

(305) 820-0095

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497874507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 W 49TH ST",
            "address_2": "SUITE 227",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122942",
            "telephone_number": "305-820-0095",
            "fax_number": "305-820-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 W 49TH ST",
            "address_2": "SUITE 227",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122942",
            "telephone_number": "305-820-0095",
            "fax_number": "305-820-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARRALERO",
        "authorized_official_first_name": "ERNESTO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-820-0095"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "HCC5602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA HEALTH CARE CLINIC",
            "identifier": "HCC5602",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nana-Stella Eugene Elort, LCSW
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• Evelyn Diagnostic & Medical Group Inc
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• Claudia Evers, DPT
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• Victor Raul Evins, M.ED.

• Specialist in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.