Provider Demographics
NPI:1578042610
Name:CMP MEDICAL CENTER CORP.
Entity Type:Organization
Organization Name:CMP MEDICAL CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELIDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-464-0673
Mailing Address - Street 1:10021 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3945
Mailing Address - Country:US
Mailing Address - Phone:786-464-0673
Mailing Address - Fax:786-464-0635
Practice Address - Street 1:10021 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3945
Practice Address - Country:US
Practice Address - Phone:786-464-0673
Practice Address - Fax:786-464-0635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty