Provider Demographics
NPI:1053617092
Name:MIAMI CARE MEDICAL CENTER
Entity type:Organization
Organization Name:MIAMI CARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:PALACIO
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:786-334-6041
Mailing Address - Street 1:550 SW 27TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2972
Mailing Address - Country:US
Mailing Address - Phone:786-334-6041
Mailing Address - Fax:786-334-6343
Practice Address - Street 1:550 SW 27TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2972
Practice Address - Country:US
Practice Address - Phone:786-334-6041
Practice Address - Fax:786-334-6343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service