Provider Demographics
NPI:1821317660
Name:MED-ONE CARE CENTER, LLC
Entity Type:Organization
Organization Name:MED-ONE CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGRM
Authorized Official - Prefix:
Authorized Official - First Name:LAJAUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-945-2675
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR
Mailing Address - Street 2:STE 260
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4707
Mailing Address - Country:US
Mailing Address - Phone:305-945-2675
Mailing Address - Fax:
Practice Address - Street 1:1380 NE MIAMI GARDENS DR
Practice Address - Street 2:STE 260
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-4707
Practice Address - Country:US
Practice Address - Phone:305-945-2675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty