MEDICARE: OMEGA MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170100000X	Ph.D. Medical Genetics	OS4921	IA

General Provider Information

NPI Number	:	1689632648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMEGA MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	8910 MIRAMAR PKWY
Second Line	:	SUITE 117
City	:	MIRAMAR
State	:	FL
Zip	:	33025-4100
Country	:	US
Telephone Number	:	786-554-8616
Fax Number	:

Provider Business Practice Location Address
First Line	:	8910 MIRAMAR PKWY
Second Line	:	SUITE 117
City	:	MIRAMAR
State	:	FL
Zip	:	33025-4100
Country	:	US
Telephone Number	:	786-554-8616
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RICARDO DIAZ
Credential	:
Telephone Number	:	786-554-8616

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	08/22/2020

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Directions to “OMEGA MEDICAL CENTER INC ” Practice Location

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