Provider Demographics
NPI:1750042230
Name:CAREMAX MEDICAL CENTERS OF CENTRAL FLORIDA, LLC
Entity Type:Organization
Organization Name:CAREMAX MEDICAL CENTERS OF CENTRAL FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:DE VERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-360-4768
Mailing Address - Street 1:8523 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3809
Mailing Address - Country:US
Mailing Address - Phone:813-889-9800
Mailing Address - Fax:813-889-9566
Practice Address - Street 1:8523 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3809
Practice Address - Country:US
Practice Address - Phone:813-889-9800
Practice Address - Fax:813-889-9566
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREMAX MEDICAL CENTERS OF CENTRAL FLORIDA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center