Provider Demographics
NPI:1326135617
Name:HUMAN CARE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:HUMAN CARE MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-267-4970
Mailing Address - Street 1:5545 SW 8TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2274
Mailing Address - Country:US
Mailing Address - Phone:305-267-4970
Mailing Address - Fax:
Practice Address - Street 1:5545 SW 8TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2274
Practice Address - Country:US
Practice Address - Phone:305-267-4970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9160Medicare ID - Type Unspecified