Provider Demographics
NPI:1760820310
Name:MAJOR MEDICAL ALLIANCE CENTER
Entity Type:Organization
Organization Name:MAJOR MEDICAL ALLIANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-785-2462
Mailing Address - Street 1:2375 NW 86TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4148
Mailing Address - Country:US
Mailing Address - Phone:866-468-1545
Mailing Address - Fax:
Practice Address - Street 1:4510 INVERRARY BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4104
Practice Address - Country:US
Practice Address - Phone:866-468-1545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service