Provider Demographics
NPI:1447589189
Name:WOODLAWN FAMILY CARE INC
Entity Type:Organization
Organization Name:WOODLAWN FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:RISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-903-5731
Mailing Address - Street 1:5727 NW 7TH ST
Mailing Address - Street 2:SUITE 261
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3105
Mailing Address - Country:US
Mailing Address - Phone:704-903-5731
Mailing Address - Fax:
Practice Address - Street 1:4044 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2617
Practice Address - Country:US
Practice Address - Phone:704-903-5731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty