Provider Demographics
NPI:1770958811
Name:RAY MIAMI MEDICAL CENTER CORP
Entity type:Organization
Organization Name:RAY MIAMI MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAUDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VELOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-238-9214
Mailing Address - Street 1:3900 NW 36 ST
Mailing Address - Street 2:594
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142
Mailing Address - Country:US
Mailing Address - Phone:786-238-9214
Mailing Address - Fax:
Practice Address - Street 1:3900 NW 36 ST
Practice Address - Street 2:594
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142
Practice Address - Country:US
Practice Address - Phone:786-238-9214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty