Provider Demographics
NPI:1699852020
Name:MIAMI MEDICAL CONSULTANTS P A
Entity Type:Organization
Organization Name:MIAMI MEDICAL CONSULTANTS P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CAVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-669-0690
Mailing Address - Street 1:4950 S LE JEUNE RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2231
Mailing Address - Country:US
Mailing Address - Phone:305-669-0690
Mailing Address - Fax:305-669-8856
Practice Address - Street 1:4950 S LE JEUNE RD
Practice Address - Street 2:SUITE H
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2231
Practice Address - Country:US
Practice Address - Phone:305-669-0690
Practice Address - Fax:305-669-8856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40002207R00000X, 207RC0200X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11947225945OtherNPI
FL96048YMedicare PIN
FL11947225945OtherNPI