Provider Demographics
NPI:1336747179
Name:IDEAL CARE MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:IDEAL CARE MEDICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUAR
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-429-3777
Mailing Address - Street 1:2188 S JOG RD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33415-6101
Mailing Address - Country:US
Mailing Address - Phone:305-300-6447
Mailing Address - Fax:
Practice Address - Street 1:2188 S JOG RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33415-6101
Practice Address - Country:US
Practice Address - Phone:561-429-3777
Practice Address - Fax:561-429-3565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty