Provider Demographics
NPI:1699577734
Name:MEDICAL CENTRAL, LLC
Entity type:Organization
Organization Name:MEDICAL CENTRAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-443-5300
Mailing Address - Street 1:114 DEL PRADO BLVD S STE 100
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1724
Mailing Address - Country:US
Mailing Address - Phone:239-471-2874
Mailing Address - Fax:
Practice Address - Street 1:11390 PALM BEACH BLVD STE 300
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-5921
Practice Address - Country:US
Practice Address - Phone:239-666-2652
Practice Address - Fax:239-666-2698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)