Provider Demographics
NPI:1619269305
Name:TAMAYO MEDICAL CENTER INC
Entity Type:Organization
Organization Name:TAMAYO MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:ARCADIO
Authorized Official - Last Name:TAMAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-445-9381
Mailing Address - Street 1:5200 SW 8TH ST
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2300
Mailing Address - Country:US
Mailing Address - Phone:305-445-9351
Mailing Address - Fax:305-445-4340
Practice Address - Street 1:5200 SW 8TH ST
Practice Address - Street 2:SUITE 201A
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2300
Practice Address - Country:US
Practice Address - Phone:305-445-9351
Practice Address - Fax:305-445-4340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51659302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization