Provider Demographics
NPI:1033316963
Name:SUPREME MEDICAL CARE INC
Entity Type:Organization
Organization Name:SUPREME MEDICAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WADDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-948-8900
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR
Mailing Address - Street 2:SUITE 138
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4707
Mailing Address - Country:US
Mailing Address - Phone:305-948-8900
Mailing Address - Fax:305-948-3911
Practice Address - Street 1:1380 NE MIAMI GARDENS DR
Practice Address - Street 2:SUITE 138
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4707
Practice Address - Country:US
Practice Address - Phone:305-948-8900
Practice Address - Fax:305-948-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty