Provider Demographics
NPI:1770209504
Name:CAREMAX MEDICAL CENTER OF BROWARD LLC
Entity type:Organization
Organization Name:CAREMAX MEDICAL CENTER OF BROWARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:DE SOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-649-8100
Mailing Address - Street 1:1000 NW 57TH CT STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3292
Mailing Address - Country:US
Mailing Address - Phone:305-649-8100
Mailing Address - Fax:
Practice Address - Street 1:8251 W BROWARD BLVD STE 310
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2703
Practice Address - Country:US
Practice Address - Phone:954-587-7577
Practice Address - Fax:954-587-7199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREMAX MEDICAL CENTER OF BROWARD, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty