Provider Demographics
NPI:1760045470
Name:CITY CARE DOCTORS INC
Entity Type:Organization
Organization Name:CITY CARE DOCTORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:DORISLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVIESO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-766-4845
Mailing Address - Street 1:14732 SW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4041
Mailing Address - Country:US
Mailing Address - Phone:786-668-6396
Mailing Address - Fax:
Practice Address - Street 1:14732 SW 56TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185
Practice Address - Country:US
Practice Address - Phone:786-668-6396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty