Healthcare Provider Details

I. General information

NPI: 1164407763
Provider Name (Legal Business Name): RITECARE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 W 49TH ST
HIALEAH FL
33012-3412
US

IV. Provider business mailing address

915 W 49TH ST
HIALEAH FL
33012-3412
US

V. Phone/Fax

Practice location:
  • Phone: 305-200-1225
  • Fax: 305-200-1225
Mailing address:
  • Phone: 415-200-2099
  • Fax: 888-972-1912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberME81042
License Number StateFL

VIII. Authorized Official

Name: MARLEY PAGE
Title or Position: DIRECTOR
Credential:
Phone: 417-861-9739