Provider Demographics
NPI:1275697377
Name:ALL DADE MEDICAL SERVICES
Entity Type:Organization
Organization Name:ALL DADE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORQUIDEA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-553-4595
Mailing Address - Street 1:8900 CORAL WAY
Mailing Address - Street 2:# 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155
Mailing Address - Country:US
Mailing Address - Phone:305-553-4595
Mailing Address - Fax:305-553-4596
Practice Address - Street 1:8900 CORAL WAY
Practice Address - Street 2:# 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:305-553-4595
Practice Address - Fax:305-553-4596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6007261QG0250X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9437Medicare PIN