Provider Demographics
NPI:1598851727
Name:MMB MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:MMB MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:BARBEITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-220-3804
Mailing Address - Street 1:125 NE 8TH ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4676
Mailing Address - Country:US
Mailing Address - Phone:305-220-3804
Mailing Address - Fax:305-223-3455
Practice Address - Street 1:125 NE 8TH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4676
Practice Address - Country:US
Practice Address - Phone:305-220-3804
Practice Address - Fax:305-223-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9068Medicare ID - Type Unspecified