Healthcare Provider Details

I. General information

NPI: 1508034042
Provider Name (Legal Business Name): CONTINUCARE MDHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 BLUE LAGOON DR SUITE 400
MIAMI FL
33126
US

IV. Provider business mailing address

6101 BLUE LAGOON DR SUITE 400
MIAMI FL
33126-2055
US

V. Phone/Fax

Practice location:
  • Phone: 305-500-2114
  • Fax: 305-370-6024
Mailing address:
  • Phone: 305-500-2114
  • Fax: 305-370-6024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GEMMA ROSELLO
Title or Position: VICE PRESIDENT
Credential:
Phone: 305-500-2000