Provider Demographics
NPI:1467173849
Name:FLORIDA CARE MEDICAL CENTER INC
Entity Type:Organization
Organization Name:FLORIDA CARE MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTERA AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:SA-C
Authorized Official - Phone:407-820-2693
Mailing Address - Street 1:10425 NW 66TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3899
Mailing Address - Country:US
Mailing Address - Phone:407-820-2693
Mailing Address - Fax:
Practice Address - Street 1:10425 NW 66TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3899
Practice Address - Country:US
Practice Address - Phone:407-820-2693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty