Provider Demographics
NPI:1326325655
Name:CARIBE MEDICAL OF HOMESTEAD, INC.
Entity Type:Organization
Organization Name:CARIBE MEDICAL OF HOMESTEAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:R
Authorized Official - Last Name:PALOMINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-258-6070
Mailing Address - Street 1:26799 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NARANJA
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7403
Mailing Address - Country:US
Mailing Address - Phone:305-258-6070
Mailing Address - Fax:305-598-0583
Practice Address - Street 1:26799 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NARANJA
Practice Address - State:FL
Practice Address - Zip Code:33032-7403
Practice Address - Country:US
Practice Address - Phone:305-258-6070
Practice Address - Fax:305-598-0583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87046208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty