Provider Demographics
NPI:1720796998
Name:MDC THERAPY CORP
Entity Type:Organization
Organization Name:MDC THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-603-6881
Mailing Address - Street 1:4538 SW 144TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6831
Mailing Address - Country:US
Mailing Address - Phone:786-603-6881
Mailing Address - Fax:
Practice Address - Street 1:4538 SW 144TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6831
Practice Address - Country:US
Practice Address - Phone:786-603-6881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty