Healthcare Provider Details

I. General information

NPI: 1003005067
Provider Name (Legal Business Name): MIAMI FAMILY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15806 SW 98TH ST
MIAMI FL
33196-6105
US

IV. Provider business mailing address

640 NW 36TH CT STE D
MIAMI FL
33125-4038
US

V. Phone/Fax

Practice location:
  • Phone: 305-586-9812
  • Fax:
Mailing address:
  • Phone: 305-631-8555
  • Fax: 305-671-3266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME81313
License Number StateFL

VIII. Authorized Official

Name: MR. RAFAEL ARTURO UBEDA
Title or Position: PRESIDENT
Credential: MD
Phone: 305-631-8555