Healthcare Provider Details

I. General information

NPI: 1295911410
Provider Name (Legal Business Name): CARE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 SW 107TH AVE SUITE # 7
MIAMI FL
33165-2470
US

IV. Provider business mailing address

2500 SW 107TH AVE SUITE # 7
MIAMI FL
33165-2470
US

V. Phone/Fax

Practice location:
  • Phone: 305-228-9517
  • Fax: 305-228-9718
Mailing address:
  • Phone: 305-228-9517
  • Fax: 305-228-9718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MARCOS LEDESMA
Title or Position: OWNER
Credential: MT
Phone: 305-228-9517