Provider Demographics
NPI:1114757044
Name:CMLA MEDICAL CENTER LLC
Entity type:Organization
Organization Name:CMLA MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:786-423-9423
Mailing Address - Street 1:1217 S MILITARY TRL STE C
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-4600
Mailing Address - Country:US
Mailing Address - Phone:561-342-5000
Mailing Address - Fax:
Practice Address - Street 1:1217 S MILITARY TRL STE C
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-4600
Practice Address - Country:US
Practice Address - Phone:561-342-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice