Provider Profile
SOLEDAD MEDICAL CENTER INC
Health Care Clinic
FACILITY PROFILE
Street Address
- 434 SW 12TH AVE STE 200
MIAMI, FL 33130
County: Miami-Dade - Phone: (786) 636-8096
Mailing Address
- 434 SW 12TH AVE STE 200
MIAMI, FL 33130
County: Miami-Dade - Phone: (954) 478-6255
AHCA Reports
Inspection ReportsInspection Details
Facility Information:
| Facility/Provider Type: | Health Care Clinic | ||||||
| Medical or Clinic Director: | Not Available | ||||||
| Administrator: | WILLIAN MENDEZ-BRAVO | ||||||
| Owner/Licensee: | SOLEDAD MEDICAL CENTER INC | ||||||
| Owner/Licensee Since: | 10/25/2019 | ||||||
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| Profit Status: | For-Profit | ||||||
| Licensed Beds: | Not Available | ||||||
| AHCA Number (File Number): | 12988 | ||||||
| AHCA Field Office: | 11 | ||||||
| License Number: | 12154 | ||||||
| Current License Effective: | 5/27/2022 | ||||||
| Current License Expires: | 5/26/2024 | ||||||
| License Status: | FAILED TO RENEW | ||||||
Services/Characteristics
| Specialty: | PIP Recipient |
| Type: | Fixed Location |
Important information and facility/provider definitions can be found in the Glossary.
Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.