Provider Demographics
NPI:1245583384
Name:M R MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:M R MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:HUMARAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:305-608-4616
Mailing Address - Street 1:8260 W FLAGLER ST
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2069
Mailing Address - Country:US
Mailing Address - Phone:305-608-4616
Mailing Address - Fax:
Practice Address - Street 1:8260 W FLAGLER ST
Practice Address - Street 2:SUITE 2G
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2069
Practice Address - Country:US
Practice Address - Phone:305-608-4616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service