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General NPI Number Information
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NPI Number | 1285724286
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Entity Type | Organization
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Legal Business Name | MEDICA HEALTHCARE PLANS, INC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1905 WEST 35 ST SUITE 105
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City | HIALEAH
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State | FL
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Zip | 33012-4534
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Country | US
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Telephone | 305-519-6090
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Fax |
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Provider Business Mailing Address
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Address Line | 4060 SW 152ND AVE
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City | MIRAMAR
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State | FL
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Zip | 33027-3365
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Country | US
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Telephone | 305-519-6090
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. EDUARDO RUBIO
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Credential |
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Telephone | 305-519-6090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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