Provider Demographics
NPI:1417676040
Name:M & Y MEDICAL CENTER INC
Entity Type:Organization
Organization Name:M & Y MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARLON
Authorized Official - Middle Name:
Authorized Official - Last Name:AZAN CALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-572-5498
Mailing Address - Street 1:9766 SW 24TH ST STE 17
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7567
Mailing Address - Country:US
Mailing Address - Phone:786-519-8130
Mailing Address - Fax:
Practice Address - Street 1:9766 SW 24TH ST STE 17
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7567
Practice Address - Country:US
Practice Address - Phone:786-519-8130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center