1801356795 NPI number — DADE MEDICAL, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801356795 NPI number — DADE MEDICAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DADE MEDICAL, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801356795
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3700 COMMERCE PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIRAMAR
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33025-3912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
844-215-4264
Provider Business Mailing Address Fax Number:
844-215-4265

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2252 COMMERCE PARK DR STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32819-8609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-215-4264
Provider Business Practice Location Address Fax Number:
844-215-4265
Provider Enumeration Date:
03/25/2019

Additional Information

Authorized Official

Authorized Official Last Name:
MENDEZ
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
844-215-4264

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100109000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 107607600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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