Provider Demographics
NPI:1154657260
Name:MEDICA HEALTH PLANS OF FLORIDA, INC.
Entity Type:Organization
Organization Name:MEDICA HEALTH PLANS OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR - SUPPORT SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:I
Authorized Official - Last Name:MORALEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-460-0600
Mailing Address - Street 1:4000 PONCE DE LEON BLVD
Mailing Address - Street 2:STE 650
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1431
Mailing Address - Country:US
Mailing Address - Phone:305-460-0600
Mailing Address - Fax:305-460-0613
Practice Address - Street 1:4000 PONCE DE LEON BLVD
Practice Address - Street 2:STE 650
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1431
Practice Address - Country:US
Practice Address - Phone:305-460-0600
Practice Address - Fax:305-460-0613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization