Healthcare Provider Details

I. General information

NPI: 1689962086
Provider Name (Legal Business Name): MONTES DE OCA MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 SW 87TH AVENUE 8-250
MIAMI FL
33173
US

IV. Provider business mailing address

7800 SW 87TH AVENUE 8-250
MIAMI FL
33173
US

V. Phone/Fax

Practice location:
  • Phone: 305-270-0576
  • Fax: 305-270-9496
Mailing address:
  • Phone: 305-270-0576
  • Fax: 305-270-9496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code132700000X
TaxonomyDietary Manager
License Number
License Number State

VIII. Authorized Official

Name: REINOLD MONTES DE OCA
Title or Position: PRESIDENT OF MEDICAL FACILITY
Credential:
Phone: 305-270-0576