Provider Demographics
NPI:1104992387
Name:FAMCARE MEDICAL CENTER INC
Entity type:Organization
Organization Name:FAMCARE MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:POVEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-883-0560
Mailing Address - Street 1:3068 PALM AVE STE C
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5449
Mailing Address - Country:US
Mailing Address - Phone:305-883-0560
Mailing Address - Fax:305-883-0760
Practice Address - Street 1:3068 PALM AVE STE C
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5449
Practice Address - Country:US
Practice Address - Phone:305-883-0560
Practice Address - Fax:305-883-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7653Medicare PIN