Provider Demographics
NPI:1215554621
Name:CAREMAX MEDICAL CENTER OF LITTLE HAVANA, L.L.C.
Entity Type:Organization
Organization Name:CAREMAX MEDICAL CENTER OF LITTLE HAVANA, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:DE VERA
Authorized Official - Suffix:
Authorized Official - Credentials:ESQUIRE
Authorized Official - Phone:786-360-4768
Mailing Address - Street 1:8700 W FLAGLER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2543
Mailing Address - Country:US
Mailing Address - Phone:786-360-4768
Mailing Address - Fax:877-551-9792
Practice Address - Street 1:1390 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3704
Practice Address - Country:US
Practice Address - Phone:786-360-4768
Practice Address - Fax:877-551-9792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center