Provider Demographics
NPI:1508569849
Name:CAREMAX MEDICAL CENTER OF BROWARD LLC
Entity Type:Organization
Organization Name:CAREMAX MEDICAL CENTER OF BROWARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:DE VERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-360-4768
Mailing Address - Street 1:1000 NW 57TH CT STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3292
Mailing Address - Country:US
Mailing Address - Phone:305-649-8100
Mailing Address - Fax:877-687-5710
Practice Address - Street 1:4302 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3780
Practice Address - Country:US
Practice Address - Phone:954-644-8902
Practice Address - Fax:877-687-5710
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREMAX MEDICAL CENTER OF BROWARD LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-24
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center