Provider Demographics
NPI:1295778017
Name:MD CARE GROUP INC
Entity type:Organization
Organization Name:MD CARE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-631-9696
Mailing Address - Street 1:330 SW. 27 AVE # 306
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135
Mailing Address - Country:US
Mailing Address - Phone:305-631-9696
Mailing Address - Fax:305-631-9611
Practice Address - Street 1:330 SW. 27 AVE # 306
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2957
Practice Address - Country:US
Practice Address - Phone:305-631-9696
Practice Address - Fax:305-631-9611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC4341OtherAHCA LICENCE
FLK4460Medicare ID - Type UnspecifiedPROVIDER NUMBER