Healthcare Provider Details

I. General information

NPI: 1497352587
Provider Name (Legal Business Name): CDR HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 NORTON DR STE 102
TALLAHASSEE FL
32308-5965
US

IV. Provider business mailing address

11740 SW 80TH ST STE 102
MIAMI FL
33183-4822
US

V. Phone/Fax

Practice location:
  • Phone: 850-738-7977
  • Fax:
Mailing address:
  • Phone: 786-235-8534
  • Fax: 786-235-8501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. TINA VIDAL-DUART
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: N/A
Phone: 786-235-8534