Provider Demographics
NPI:1770974032
Name:DOCTORS MEDICAL CENTER INC
Entity type:Organization
Organization Name:DOCTORS MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:VENTURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-685-5688
Mailing Address - Street 1:1200 NE 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5936
Mailing Address - Country:US
Mailing Address - Phone:305-685-5688
Mailing Address - Fax:786-693-7731
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:SUITE 118
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3825
Practice Address - Country:US
Practice Address - Phone:305-835-0438
Practice Address - Fax:305-693-0768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site