Provider Demographics
NPI:1104869593
Name:ORD MEDICAL CENTER INC
Entity type:Organization
Organization Name:ORD MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:OSMANI
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-267-4484
Mailing Address - Street 1:8578 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4053
Mailing Address - Country:US
Mailing Address - Phone:305-267-4484
Mailing Address - Fax:305-267-4406
Practice Address - Street 1:8578 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4053
Practice Address - Country:US
Practice Address - Phone:305-267-4484
Practice Address - Fax:305-267-4406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8737CMedicare ID - Type UnspecifiedDR MEDICARE NUMBER
FLH81862Medicare UPIN
FLK8427Medicare ID - Type UnspecifiedPROVIDER GROUP NUMBER