Provider Demographics
NPI:1871835140
Name:CONTINUCARE MEDICAL CENTER
Entity Type:Organization
Organization Name:CONTINUCARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP SUPPORT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-500-2108
Mailing Address - Street 1:7200 CORPORATE CENTER DR
Mailing Address - Street 2:600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1200
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:305-500-2080
Practice Address - Street 1:228 W ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-7157
Practice Address - Country:US
Practice Address - Phone:813-754-5480
Practice Address - Fax:813-754-2251
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTINUCARE MEDICAL MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-25
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site