Provider Demographics
NPI:1063433126
Name:THE MEDICAL CENTER AT OCEAN REEF
Entity type:Organization
Organization Name:THE MEDICAL CENTER AT OCEAN REEF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-367-2600
Mailing Address - Street 1:30 OCEAN REEF DR
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-5222
Mailing Address - Country:US
Mailing Address - Phone:305-367-2600
Mailing Address - Fax:305-367-4573
Practice Address - Street 1:30 OCEAN REEF DR
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-5222
Practice Address - Country:US
Practice Address - Phone:305-367-2600
Practice Address - Fax:305-367-4573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7554207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty