Provider Demographics
NPI:1326034331
Name:STREBOR MEDICAL CENTER INC
Entity Type:Organization
Organization Name:STREBOR MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-895-3231
Mailing Address - Street 1:1175 NE 125TH ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5015
Mailing Address - Country:US
Mailing Address - Phone:305-895-3231
Mailing Address - Fax:
Practice Address - Street 1:1175 NE 125TH ST
Practice Address - Street 2:SUITE 306
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5015
Practice Address - Country:US
Practice Address - Phone:305-895-3231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-25
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0076863261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG77491Medicare UPIN
FLE6757Medicare ID - Type Unspecified