Provider Demographics
NPI:1033961354
Name:HOUSE CALLS MEDICAL CARE
Entity Type:Organization
Organization Name:HOUSE CALLS MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LA
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTERO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-286-7640
Mailing Address - Street 1:2744 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3200
Mailing Address - Country:US
Mailing Address - Phone:786-286-7640
Mailing Address - Fax:
Practice Address - Street 1:2744 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3200
Practice Address - Country:US
Practice Address - Phone:786-286-7640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine