Provider Demographics
NPI:1487618997
Name:VARADERO MEDICAL CENTER OF MIAMI
Entity type:Organization
Organization Name:VARADERO MEDICAL CENTER OF MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-263-9590
Mailing Address - Street 1:7925 NW 12TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1821
Mailing Address - Country:US
Mailing Address - Phone:305-874-3909
Mailing Address - Fax:305-874-3916
Practice Address - Street 1:5850 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3363
Practice Address - Country:US
Practice Address - Phone:305-263-9590
Practice Address - Fax:305-263-9657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25378OtherBCBS OF FL
FL274237300Medicaid
FL25378OtherBCBS OF FL
FL274237300Medicaid