Healthcare Provider Details

I. General information

NPI: 1164107355
Provider Name (Legal Business Name): CAREMAX MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2023
Last Update Date: 11/02/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 MALABAR ROAD SE
PALM BAY FL
32907
US

IV. Provider business mailing address

1000 NW 57TH CT STE 400
MIAMI FL
33126-3292
US

V. Phone/Fax

Practice location:
  • Phone: 321-325-6420
  • Fax: 321-325-6421
Mailing address:
  • Phone: 305-649-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSEPH N DE VERA
Title or Position: RA
Credential:
Phone: 305-649-8100