Provider Demographics
NPI:1043240260
Name:FIRST MEDICAL CENTER, INC,
Entity Type:Organization
Organization Name:FIRST MEDICAL CENTER, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-821-2182
Mailing Address - Street 1:15495 EAGLE NEST LN
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2266
Mailing Address - Country:US
Mailing Address - Phone:305-821-2182
Mailing Address - Fax:305-821-0987
Practice Address - Street 1:15495 EAGLE NEST LN
Practice Address - Street 2:SUITE 230
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2266
Practice Address - Country:US
Practice Address - Phone:305-821-2182
Practice Address - Fax:305-821-0987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID #
FL=========OtherTAX ID #