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General NPI Number Information
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NPI Number | 1386686749
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Entity Type | Organization
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Legal Business Name | MED - CARE CLINIC INC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 735 NW 22ND AVE UNIT A
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City | MIAMI
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State | FL
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Zip | 33125-3339
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Country | US
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Telephone | 305-642-1622
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Fax | 305-642-1197
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Provider Business Mailing Address
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Address Line | 735 NW 22ND AVE UNIT A
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City | MIAMI
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State | FL
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Zip | 33125-3339
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Country | US
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Telephone | 305-642-1622
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Fax | 305-642-1197
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. FRANCISCO A MADURO
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Credential |
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Telephone | 305-642-1622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | HCC7063
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License Number State | FL
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