Provider Demographics
NPI:1578229472
Name:MDO HEALTHCARE MANAGEMENT AND SERVICES INC
Entity Type:Organization
Organization Name:MDO HEALTHCARE MANAGEMENT AND SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MA DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:954-871-1119
Mailing Address - Street 1:9999 NE 2ND AVE STE 219
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2345
Mailing Address - Country:US
Mailing Address - Phone:954-871-1119
Mailing Address - Fax:305-614-8602
Practice Address - Street 1:9999 NE 2ND AVE STE 219
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2345
Practice Address - Country:US
Practice Address - Phone:954-871-1119
Practice Address - Fax:305-614-8602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty