MEDICARE: DOCTOR'S MEDICAL CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	332900000X	Non-Pharmacy Dispensing Site
3	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215981618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTOR'S MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	5605 NW 82ND AVE
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33166-4000
Country	:	US
Telephone Number	:	305-685-5688
Fax Number	:	786-618-5307

Provider Business Practice Location Address
First Line	:	1272 NW 119TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33167-3232
Country	:	US
Telephone Number	:	305-685-5688
Fax Number	:	305-687-1817

Authorized Official
Title or Position	:	PRESIDENT/ CEO
Name	:	VENTURA DE PAZ
Credential	:	PA
Telephone Number	:	305-685-5688

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	04/02/2021

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MEDICARE: DOCTOR'S MEDICAL CENTER, LLC

Scope of Practice

Other Identifiers

General Provider Information

Similar Medicare Providers

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