Healthcare Provider Details

I. General information

NPI: 1306033303
Provider Name (Legal Business Name): CONTINUCARE MEDICAL MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 BLUE LAGOON DR SUITE 400
MIAMI FL
33126-2055
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: 305-500-2145
Mailing address:
  • Phone: 305-500-2114
  • Fax: 305-500-2145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number StateFL
# 2
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