Provider Demographics
NPI:1164807335
Name:CORAL GABLES MEDICAL CENTER INC
Entity Type:Organization
Organization Name:CORAL GABLES MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALTAGRACIA
Authorized Official - Middle Name:ADALGIZA
Authorized Official - Last Name:VICTORIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-297-2852
Mailing Address - Street 1:5500 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2220
Mailing Address - Country:US
Mailing Address - Phone:305-441-9399
Mailing Address - Fax:305-442-5409
Practice Address - Street 1:5500 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2220
Practice Address - Country:US
Practice Address - Phone:305-441-9399
Practice Address - Fax:305-442-5409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty