Healthcare Provider Details

I. General information

NPI: 1295768661
Provider Name (Legal Business Name): MIAMI DADE HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8506 SW 8TH ST
MIAMI FL
33144-4053
US

IV. Provider business mailing address

8506 SW 8TH ST
MIAMI FL
33144-4053
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-6070
  • Fax: 305-262-8940
Mailing address:
  • Phone: 305-262-6070
  • Fax: 305-262-8940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberME 92214
License Number StateFL

VIII. Authorized Official

Name: ISMAEL LABRADOR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 305-244-2546