Healthcare Provider Details

I. General information

NPI: 1487618997
Provider Name (Legal Business Name): VARADERO MEDICAL CENTER OF MIAMI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 W FLAGLER ST
MIAMI FL
33144-3363
US

IV. Provider business mailing address

7925 NW 12TH ST STE 201
DORAL FL
33126-1821
US

V. Phone/Fax

Practice location:
  • Phone: 305-263-9590
  • Fax: 305-263-9657
Mailing address:
  • Phone: 305-874-3909
  • Fax: 305-874-3916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PEDRO R CARO
Title or Position: DIRECTOR
Credential: M.D.
Phone: 305-263-9590