Provider Demographics
NPI:1700175858
Name:UNIDAD OF MIAMI BEACH, INC
Entity Type:Organization
Organization Name:UNIDAD OF MIAMI BEACH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPEDA-LEONARDO
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:305-867-0051
Mailing Address - Street 1:1701 NORMANDY DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4703
Mailing Address - Country:US
Mailing Address - Phone:305-867-0051
Mailing Address - Fax:305-538-3040
Practice Address - Street 1:1701 NORMANDY DR
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-4703
Practice Address - Country:US
Practice Address - Phone:305-867-0051
Practice Address - Fax:305-538-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL501 (C3)251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid
FLPENDINGMedicare PIN