Provider Demographics
NPI:1801279716
Name:INTERMED MEDICAL RESEARCH CENTER, INC
Entity type:Organization
Organization Name:INTERMED MEDICAL RESEARCH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MELGAREJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-351-6176
Mailing Address - Street 1:13055 SW 42ND ST
Mailing Address - Street 2:SUITE: 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3406
Mailing Address - Country:US
Mailing Address - Phone:305-351-6176
Mailing Address - Fax:
Practice Address - Street 1:13055 SW 42ND ST
Practice Address - Street 2:SUITE: 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3406
Practice Address - Country:US
Practice Address - Phone:305-351-6176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch