1780788463 NPI number — CITY OF HIALEAH

Table of content: (NPI 1780788463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780788463 NPI number — CITY OF HIALEAH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF HIALEAH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780788463
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 918660
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32891-8660
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-883-6900
Provider Business Mailing Address Fax Number:
305-883-6980

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
83 E 5TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33010-4834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-883-6900
Provider Business Practice Location Address Fax Number:
305-883-6980
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FLYNN
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
305-883-6909

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 400007200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00215460 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 400007200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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