Provider Demographics
NPI:1285137760
Name:MC&D MEDICAL CORPORATION INC
Entity type:Organization
Organization Name:MC&D MEDICAL CORPORATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CASAS BUCHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-663-8524
Mailing Address - Street 1:19150 NW 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-2145
Mailing Address - Country:US
Mailing Address - Phone:786-663-8524
Mailing Address - Fax:
Practice Address - Street 1:19150 NW 44TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-2145
Practice Address - Country:US
Practice Address - Phone:786-663-8524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty