Provider Demographics
NPI:1598173296
Name:HOMESTEAD MEDICAL RESEARCH, INC.
Entity Type:Organization
Organization Name:HOMESTEAD MEDICAL RESEARCH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:786-339-8454
Mailing Address - Street 1:830 N KROME AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4407
Mailing Address - Country:US
Mailing Address - Phone:786-339-8454
Mailing Address - Fax:786-601-2705
Practice Address - Street 1:830 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4407
Practice Address - Country:US
Practice Address - Phone:786-339-8454
Practice Address - Fax:786-601-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS54771744R1102X
FLME623771744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty