EBENEZER MEDICAL CENTER LLC (NPI# 1134642465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134642465 |
| Entity Type | Organization |
| Organization Name | EBENEZER MEDICAL CENTER LLC |
| Other Organization Name | EBENEZERMED |
| Practice Address |
646 W Palm Dr Homestead FL 33034-3208 |
| Practice Telephone | (305) 330-5393 |
| Practice Fax Number | 3057730220 |
| Mailing Telephone | 3053305393 |
| Mailing Fax Number | 3057730220 |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |
| Authorized Official Name | RENE ELADIO DISOTUAR ABAD (PRESIDENT) |
| Authorized Official Telephone | 3053305393 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 010733300 | 05 |
| Other Name | Type Code |
|---|---|
| EBENEZERMED | Former Legal Business Name - Organization |
| Street Address |
646 W PALM DR |
| City | HOMESTEAD |
| State | FL |
| Zip Code | 33034-3208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184861981 | The Family Dental Care Center | Dentist | 646 W Palm Dr, Homestead, FL 33034-3208 | 2009-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497310114 | Aprea Home Health Inc. | Assisted Living Facility | 840 Sw 5 Street, Florida City, FL 33034 | 2019-05-08 |
| 1700371549 | Daniel Max & Marcandrea LLC | Optometrist | 33497 S Dixie Hwy Ste 102, Florida City, FL 33034 | 2018-06-25 |
| 1003313404 | Aigbovboise Ayo Ehabahe | Behavior Technician | 341 Ne 2nd Street Apt. 105, Florida City, FL 33034 | 2018-04-11 |
| 1164924619 | Martinez Transportation Inc | Non-emergency Medical Transport (VAN) | 335 S Krome City, Florida City, FL 33034 | 2018-03-01 |
| 1700385457 | Penelope A Zaiter | Nurse Practitioner | 530 Sw 1st Street, Florida City, FL 33034 | 2018-02-08 |
| 1750890661 | Dennis Estrada Rodrigo | Behavior Technician | 1149 Independence Trail Apt K, Homestead, FL 33034 | 2017-09-22 |
| 1649799396 | Nelsaelena Suarez | Behavior Technician | 833 Sw 5 St, Florida City, FL 33034 | 2017-09-13 |
| 1851837249 | Yudelis Anzardo | Behavior Technician | 36401 Sw 214 Ave, Homestead, FL 33034 | 2017-01-10 |
| 1265780514 | Jorge Adalberto Aguilar | General Practice | 19000 Sw 377th. Street, Dade Correctional Institution, Homestead, FL 33034 | 2012-08-16 |
| 1205106051 | Karen Ivette Fernandez De Castro | Occupational Therapist | 756 West Palm Drive, Florida City, FL 33034 | 2012-01-11 |
| Find all providers in zip 33034 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295039113 | Healthworks Med Group of Florida P A | Clinic/Center | 9700 Sw 344th St, Homestead, FL 33035-1800 | 2011-01-06 |
| 1528603818 | Greenleaf Compassion LLC | Clinic/Center | 330 E 8th Ave, Homestead, PA 15120-1518 | 2019-11-11 |
| 1912390717 | Florimed Medical Center | Clinic/Center | 311 Ne 8th St, Suite 110, Homestead, FL 33030-4738 | 2015-03-18 |
| 1144657941 | Valid Mde, Inc | Clinic/Center | 139 Ne 15th St, Homestead, FL 33030-4508 | 2013-10-11 |
| 1790046761 | Arles Perdomo M.d. Pa | Clinic/Center | 311 Ne 8th St, Suite 110, Homestead, FL 33030-4738 | 2012-06-06 |
| 1538480413 | Shs Medical Center of Homestead, LLC | Clinic/Center | 38 Nw 8th St, Homestead, FL 33030-4405 | 2010-06-15 |
| 1225252232 | Homestead Family Medical Center | Clinic/Center | 909 N Krome Ave, Homestead, FL 33030-4408 | 2007-04-12 |
| 1619016185 | Lisette Vazquez Do Pa | Clinic/Center | 909 N Krome Ave, Homestead, FL 33030-4408 | 2007-02-05 |
| 1043358658 | Sonia Talarico Do Mph Pa | Clinic/Center | 909 N Krome Ave, Homestead, FL 33030-4408 | 2007-02-03 |
| 1316007321 | Family Pediatrics, P.a. | Clinic/Center | 311 Ne 8th St, Suite # 109, Homestead, FL 33030-4738 | 2006-12-11 |
| Find all providers in HOMESTEAD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.