MEDICARE: MED - CARE CLINIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	HCC7063	FL

General Provider Information

NPI Number	:	1386686749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED - CARE CLINIC INC

Provider Business Mailing Address
First Line	:	735 NW 22ND AVE
Second Line	:	UNIT A
City	:	MIAMI
State	:	FL
Zip	:	33125-3339
Country	:	US
Telephone Number	:	305-642-1622
Fax Number	:	305-642-1197

Provider Business Practice Location Address
First Line	:	735 NW 22ND AVE
Second Line	:	UNIT A
City	:	MIAMI
State	:	FL
Zip	:	33125-3339
Country	:	US
Telephone Number	:	305-642-1622
Fax Number	:	305-642-1197

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. FRANCISCO A MADURO
Credential	:
Telephone Number	:	305-642-1622

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/07/2007

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Directions to “MED - CARE CLINIC INC ” Practice Location

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