Provider Demographics
NPI:1134681893
Name:CAREMAX MEDICAL CENTER OF TAMARAC LLC
Entity Type:Organization
Organization Name:CAREMAX MEDICAL CENTER OF TAMARAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RA
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:DE VERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-200-8305
Mailing Address - Street 1:1000 NW 57TH CT STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3292
Mailing Address - Country:US
Mailing Address - Phone:305-649-8100
Mailing Address - Fax:
Practice Address - Street 1:7800 N UNIVERSITY DR # 101-204
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2128
Practice Address - Country:US
Practice Address - Phone:954-670-1170
Practice Address - Fax:954-670-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center