Provider Demographics
NPI:1497352587
Name:CDR HEALTH CARE INC
Entity Type:Organization
Organization Name:CDR HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIDAL-DUART
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:786-235-8534
Mailing Address - Street 1:11740 SW 80TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4822
Mailing Address - Country:US
Mailing Address - Phone:786-235-8534
Mailing Address - Fax:786-235-8501
Practice Address - Street 1:313 NORTON DR STE 102
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5965
Practice Address - Country:US
Practice Address - Phone:850-738-7977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty