Provider Demographics
NPI:1457635286
Name:DADE FAMILY MEDICAL CERTER
Entity Type:Organization
Organization Name:DADE FAMILY MEDICAL CERTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-774-9570
Mailing Address - Street 1:4343 W FLAGLER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1585
Mailing Address - Country:US
Mailing Address - Phone:305-774-9570
Mailing Address - Fax:305-774-9573
Practice Address - Street 1:4343 W FLAGLER ST STE 100
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1585
Practice Address - Country:US
Practice Address - Phone:305-774-9570
Practice Address - Fax:305-774-9573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care