Provider Demographics
NPI:1659840866
Name:CARE4USMD
Entity type:Organization
Organization Name:CARE4USMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-432-0893
Mailing Address - Street 1:2220 COUNTY RD 210 WEST
Mailing Address - Street 2:SIUTE 108 PMB 119
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259
Mailing Address - Country:US
Mailing Address - Phone:904-274-4988
Mailing Address - Fax:904-212-2363
Practice Address - Street 1:14866 OLD SAINT AUGUSTINE RD STE 113
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2611
Practice Address - Country:US
Practice Address - Phone:904-274-4988
Practice Address - Fax:904-212-2363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care