Provider Demographics
NPI:1174587778
Name:MERCY'S HEALTH INC.
Entity type:Organization
Organization Name:MERCY'S HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT TO THE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DIEGO
Authorized Official - Middle Name:J
Authorized Official - Last Name:GANUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-962-0355
Mailing Address - Street 1:8200 NW 27TH ST
Mailing Address - Street 2:SUITE 117
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1902
Mailing Address - Country:US
Mailing Address - Phone:305-716-8637
Mailing Address - Fax:305-716-8693
Practice Address - Street 1:8200 NW 27TH ST
Practice Address - Street 2:SUITE 117
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1902
Practice Address - Country:US
Practice Address - Phone:305-716-8637
Practice Address - Fax:305-716-8693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5370Medicare ID - Type UnspecifiedPROVIDER NUMBER