Provider Demographics
NPI:1194850354
Name:D & R MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:D & R MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-643-7833
Mailing Address - Street 1:1830 NW 7TH ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3569
Mailing Address - Country:US
Mailing Address - Phone:305-643-7833
Mailing Address - Fax:305-643-7834
Practice Address - Street 1:1830 NW 7TH ST
Practice Address - Street 2:SUITE 222
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3569
Practice Address - Country:US
Practice Address - Phone:305-643-7833
Practice Address - Fax:305-643-7834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7200261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center