Provider Demographics
NPI:1578302105
Name:MIL SONRISAS MEDICAL CENTER INC
Entity type:Organization
Organization Name:MIL SONRISAS MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANELYS
Authorized Official - Middle Name:FUENTES
Authorized Official - Last Name:GALIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-312-0513
Mailing Address - Street 1:2721 NW 42ND AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-5623
Mailing Address - Country:US
Mailing Address - Phone:786-312-0513
Mailing Address - Fax:
Practice Address - Street 1:2721 NW 42ND AVE STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-5623
Practice Address - Country:US
Practice Address - Phone:786-312-0513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health