Provider Demographics
NPI:1588768279
Name:COUNTY OF DADE BOARD OF COUNTY COMMISSIONERS
Entity type:Organization
Organization Name:COUNTY OF DADE BOARD OF COUNTY COMMISSIONERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR, ADMINISTRATIVE
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-331-5253
Mailing Address - Street 1:PO BOX 947330
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-7330
Mailing Address - Country:US
Mailing Address - Phone:855-313-6027
Mailing Address - Fax:877-992-6934
Practice Address - Street 1:9300 NW 41ST ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2312
Practice Address - Country:US
Practice Address - Phone:786-331-4623
Practice Address - Fax:786-331-4621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3375341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
407590188OtherRAILROAD MEDICARE
FL083899301Medicaid
FLA0508OtherPART B MEDICARE #
FL083899301Medicaid