Provider Demographics
NPI:1689962086
Name:MONTES DE OCA MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:MONTES DE OCA MEDICAL CENTER INC.
Other - Org Name:RICHARD E. KOWALSKY, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OF MEDICAL FACILITY
Authorized Official - Prefix:
Authorized Official - First Name:REINOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTES DE OCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-270-0576
Mailing Address - Street 1:7800 SW 87TH AVENUE
Mailing Address - Street 2:8-250
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-270-0576
Mailing Address - Fax:305-270-9496
Practice Address - Street 1:7800 SW 87TH AVENUE
Practice Address - Street 2:8-250
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:305-270-0576
Practice Address - Fax:305-270-9496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes132700000XDietary & Nutritional Service ProvidersDietary ManagerGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26716OtherMEDICAL DOCTOR