Provider Demographics
NPI:1740697325
Name:DE CESPEDES MEDICAL CENTER LLC
Entity type:Organization
Organization Name:DE CESPEDES MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:CRISTINA
Authorized Official - Last Name:DE CESPEDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-432-8887
Mailing Address - Street 1:9833 E HIBISCUS ST UNIT 571136
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33257-5075
Mailing Address - Country:US
Mailing Address - Phone:954-432-8887
Mailing Address - Fax:954-432-8808
Practice Address - Street 1:3085 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4424
Practice Address - Country:US
Practice Address - Phone:954-432-8887
Practice Address - Fax:954-432-8808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62701207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty