Provider Demographics
NPI:1629065941
Name:METROPOLITAN HEALTH NETWORKS LT BLUE ZONE
Entity Type:Organization
Organization Name:METROPOLITAN HEALTH NETWORKS LT BLUE ZONE
Other - Org Name:METCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-805-8500
Mailing Address - Street 1:250 S AUSTRALIAN AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5018
Mailing Address - Country:US
Mailing Address - Phone:561-805-8500
Mailing Address - Fax:561-805-8501
Practice Address - Street 1:18300 NE 19TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-5000
Practice Address - Country:US
Practice Address - Phone:305-949-7273
Practice Address - Fax:305-949-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
40730AMedicare ID - Type Unspecified