Provider Demographics
NPI:1154803021
Name:CAREMAX MEDICAL CENTER OF CORAL WAY, L.L.C.
Entity type:Organization
Organization Name:CAREMAX MEDICAL CENTER OF CORAL WAY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:DE SOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-649-8100
Mailing Address - Street 1:1000 NW 57TH CT STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3292
Mailing Address - Country:US
Mailing Address - Phone:305-649-8100
Mailing Address - Fax:
Practice Address - Street 1:1757 SW 22ND ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-2728
Practice Address - Country:US
Practice Address - Phone:786-442-1040
Practice Address - Fax:786-567-4476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-06
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center