MEDICARE: OCCUPATIONAL MEDICAL CENTER 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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1902916646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL MEDICAL CENTER INC.

Provider Business Mailing Address
First Line	:	3270 NW 36TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-5036
Country	:	US
Telephone Number	:	305-634-4522
Fax Number	:

Provider Business Practice Location Address
First Line	:	3270 NW 36TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-5036
Country	:	US
Telephone Number	:	305-634-4522
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RANDALL M ADERMAN
Credential	:
Telephone Number	:	305-635-1445

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	09/03/2008

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