Provider Demographics
NPI:1942479696
Name:CONTINUCARE MEDICAL MANAGEMENT, INC
Entity Type:Organization
Organization Name:CONTINUCARE MEDICAL MANAGEMENT, INC
Other - Org Name:TONY A. DIXON, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:PFENNIGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:305-500-2000
Mailing Address - Street 1:7200 CORPORATE CENTER DR
Mailing Address - Street 2:SUITE 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:305-500-2145
Practice Address - Street 1:6971 W SUNRISE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-4407
Practice Address - Country:US
Practice Address - Phone:954-321-7700
Practice Address - Fax:954-584-4514
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTINUCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57237332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE73094Medicare UPIN