Provider Demographics
NPI:1235173063
Name:A'S MEDICAL CENTER INC
Entity Type:Organization
Organization Name:A'S MEDICAL CENTER INC
Other - Org Name:A'S MEDICAL CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-551-5040
Mailing Address - Street 1:3850 SW 87TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5400
Mailing Address - Country:US
Mailing Address - Phone:305-551-5040
Mailing Address - Fax:305-551-5024
Practice Address - Street 1:3850 SW 87TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5400
Practice Address - Country:US
Practice Address - Phone:305-551-5040
Practice Address - Fax:305-551-5024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLK8288261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8288Medicare ID - Type UnspecifiedMEDICARE ROV FOR OFFICE
FL11484AMedicare ID - Type UnspecifiedDR MEDICARE PROVIDER NUMB
FLE60476Medicare UPIN