Provider Demographics
NPI:1982971867
Name:CAREVANTAGE MEDICAL CENTERS OF MIAMI AT HIALEAH LLC
Entity Type:Organization
Organization Name:CAREVANTAGE MEDICAL CENTERS OF MIAMI AT HIALEAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMADRID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-691-1110
Mailing Address - Street 1:4445 WEST 16TH AVENUE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3205
Mailing Address - Country:US
Mailing Address - Phone:305-558-8687
Mailing Address - Fax:305-558-8097
Practice Address - Street 1:4445 WEST 16TH AVENUE
Practice Address - Street 2:SUITE 501
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3205
Practice Address - Country:US
Practice Address - Phone:305-558-8687
Practice Address - Fax:305-558-8097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty