Provider Demographics
NPI:1609067990
Name:ADCARE MEDICAL CENTER
Entity Type:Organization
Organization Name:ADCARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-225-3740
Mailing Address - Street 1:8386 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3355
Mailing Address - Country:US
Mailing Address - Phone:305-225-3740
Mailing Address - Fax:305-225-3448
Practice Address - Street 1:8386 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3355
Practice Address - Country:US
Practice Address - Phone:305-225-3740
Practice Address - Fax:305-225-3448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization