Healthcare Provider Details

I. General information

NPI: 1164191565
Provider Name (Legal Business Name): CAREMAX MEDICAL CENTERS OF CENTRAL FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4227 13TH ST
SAINT CLOUD FL
34769-6732
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 321-235-6230
  • Fax:
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: CARLOS DE SOLO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 305-649-8100