Provider Demographics
NPI:1083631766
Name:DYNASTY CARE MEDICAL CENTER INC
Entity Type:Organization
Organization Name:DYNASTY CARE MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-266-7673
Mailing Address - Street 1:5840 SW 8TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5051
Mailing Address - Country:US
Mailing Address - Phone:305-266-7673
Mailing Address - Fax:305-266-7675
Practice Address - Street 1:5840 SW 8TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5051
Practice Address - Country:US
Practice Address - Phone:305-266-7673
Practice Address - Fax:305-266-7675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty