Provider Demographics
NPI:1538189071
Name:FALLS MEDICAL CARE, INC.
Entity type:Organization
Organization Name:FALLS MEDICAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-430-8000
Mailing Address - Street 1:8353 SW 124TH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5851
Mailing Address - Country:US
Mailing Address - Phone:786-430-8000
Mailing Address - Fax:786-430-8800
Practice Address - Street 1:8353 SW 124TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-5851
Practice Address - Country:US
Practice Address - Phone:786-430-8000
Practice Address - Fax:786-430-8800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4142208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4765Medicare ID - Type UnspecifiedMEDICARE