Provider Demographics
NPI:1114319266
Name:VARADERO MEDICAL RESEARCH CENTER, LLC
Entity Type:Organization
Organization Name:VARADERO MEDICAL RESEARCH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEMIS
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:EXPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-263-9590
Mailing Address - Street 1:5850 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3363
Mailing Address - Country:US
Mailing Address - Phone:305-263-9590
Mailing Address - Fax:305-263-9657
Practice Address - Street 1:5850 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3363
Practice Address - Country:US
Practice Address - Phone:305-263-9590
Practice Address - Fax:305-263-9657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15000018030261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch