Provider Demographics
NPI:1295360378
Name:DI MARE MEDICAL SERVICES CORP.
Entity Type:Organization
Organization Name:DI MARE MEDICAL SERVICES CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMARE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-389-4156
Mailing Address - Street 1:10975 SW 174TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-4063
Mailing Address - Country:US
Mailing Address - Phone:786-389-4156
Mailing Address - Fax:305-964-5200
Practice Address - Street 1:4445 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7189
Practice Address - Country:US
Practice Address - Phone:305-558-8687
Practice Address - Fax:305-558-8097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty