Interstate Medical Center Corp

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

INTERSTATE MEDICAL CENTER CORP

Practice address

4228 W 16TH Ave
Hialeah, FL 33012-7624

Phone

(516) 737-8420

NPI assigned

Oct 19, 2015

Last updated

Oct 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Osvaldo Fernandez

Title

President

Phone

(516) 737-8420

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1649641481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 W 16TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 W 16TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127624",
            "telephone_number": "516-737-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSTATE MEDICAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "OSVALDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-737-8420"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Hialeah, FL
• Providers in Hialeah, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.