Provider Demographics
NPI:1639447444
Name:CARIBE MEDICAL CENTER OF HOMESTEAD
Entity Type:Organization
Organization Name:CARIBE MEDICAL CENTER OF HOMESTEAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:I
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:305-258-6070
Mailing Address - Street 1:26799 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NARANJA
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7403
Mailing Address - Country:US
Mailing Address - Phone:305-258-6070
Mailing Address - Fax:
Practice Address - Street 1:26799 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NARANJA
Practice Address - State:FL
Practice Address - Zip Code:33032-7403
Practice Address - Country:US
Practice Address - Phone:305-258-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA40473OtherCMT