Provider Demographics
NPI:1558348805
Name:DC HEALTH MANAGEMENT INC
Entity Type:Organization
Organization Name:DC HEALTH MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:CASANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-773-3491
Mailing Address - Street 1:3737 SW 8TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3121
Mailing Address - Country:US
Mailing Address - Phone:305-529-0225
Mailing Address - Fax:305-448-1193
Practice Address - Street 1:3737 SW 8TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3121
Practice Address - Country:US
Practice Address - Phone:305-529-0225
Practice Address - Fax:305-448-1193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4719261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4187Medicare PIN