Healthcare Provider Details

I. General information

NPI: 1285611913
Provider Name (Legal Business Name): QUALMED OF SOUTH DADE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 01/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27535 S DIXIE HWY
NARANJA FL
33032-8225
US

IV. Provider business mailing address

26085 S DIXIE HWY
NARANJA FL
33032-6613
US

V. Phone/Fax

Practice location:
  • Phone: 305-246-2221
  • Fax: 305-269-8825
Mailing address:
  • Phone: 305-246-2221
  • Fax: 305-269-8825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MS. SANDRA MARIA PALACIO
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 305-398-0807