Provider Demographics
NPI:1881422434
Name:FLORIDA CARE MEDICAL CENTER INC
Entity type:Organization
Organization Name:FLORIDA CARE MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:LASTRES HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-558-5772
Mailing Address - Street 1:7200 CURRY FORD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-5806
Mailing Address - Country:US
Mailing Address - Phone:407-588-8284
Mailing Address - Fax:407-706-8284
Practice Address - Street 1:810 N NOWELL ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7539
Practice Address - Country:US
Practice Address - Phone:407-588-8284
Practice Address - Fax:407-706-8284
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA CARE MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-24
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty