Provider Demographics
NPI:1508263872
Name:CONTINUCARE MEDICAL MANAGEMENT INC
Entity Type:Organization
Organization Name:CONTINUCARE MEDICAL MANAGEMENT INC
Other - Org Name:CONTINUCARE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-500-2000
Mailing Address - Street 1:7200 CORPORATE CENTER DR
Mailing Address - Street 2:#600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1200
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:305-500-2000
Practice Address - Street 1:2500 E HALLANDALE BEACH BLVD STE QR
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4834
Practice Address - Country:US
Practice Address - Phone:954-456-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTINUCARE MEDICAL MANAGEMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-02
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site