INTERNATIONAL RECOVERY CENTER LLC (NPI# 1053865642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053865642 |
| Entity Type | Organization |
| Organization Name | INTERNATIONAL RECOVERY CENTER LLC |
| Practice Address |
1825 Nw 112th Ave Ste 151 Miami FL 33172-1815 |
| Practice Telephone | 3056101747 |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |
| Authorized Official Name | MR. ALEXANDER M FUNDORA (CEO) |
| Authorized Official Telephone | 3056101747 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
1825 NW 112TH AVE STE 151 |
| City | MIAMI |
| State | FL |
| Zip Code | 33172-1815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710438338 | International Recovery Center, LLC | Clinic/Center | 1825 Nw 112th Ave, Suite 151, Miami, FL 33172-1815 | 2016-10-19 |
| 1679023766 | International Recovery Center | Substance Abuse Rehabilitation Facility | 1825 Nw 112th Ave, Suite 151, Miami, FL 33172-1815 | 2016-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801366463 | Magela De Las Mercedes Rodriguez | Behavior Technician | 11252 Nw 6 Street, Miami, FL 33172 | 2018-11-27 |
| 1477030666 | Natacha Garcia | Behavior Technician | 181 Nw 97 Ave Apto 416, Miami, FL 33172 | 2018-07-20 |
| 1720578701 | Marisela Hernandez | Behavioral Analyst | 10825 Nw 7th St Apt 12, Miami, FL 33172 | 2018-05-15 |
| 1083113054 | Fuerza Vital Medical Institute, Corp | Speech-Language Pathologist | 8725 Nw 18 Terr Suite 209, Doral, FL 33172 | 2018-02-06 |
| 1063923522 | Kristen Nicole Otero | Counselor | 1414 Nw 107 Ave Suite 109, Doral, FL 33172 | 2017-10-23 |
| 1003327339 | All Orthopedic Supplies Corp | Prosthetic/Orthotic Supplier | 175 Fontainbleau Blvd, Ste P1, Miami, FL 33172 | 2017-10-13 |
| 1861901944 | Lyanne M Melendez | Speech-Language Pathologist | 1750 Nw 107 Ave, Unit P-901, Miami, FL 33172 | 2017-09-21 |
| 1295259166 | Family Tender Care Services Inc | Behavioral Analyst | 9360 Fontainebleau Blvd, Unit 514, Miami, FL 33172 | 2017-08-01 |
| 1992229074 | Maria F Palabez | Behavior Technician | 9369 Fontainebleau Blvd J225, Miami, FL 33172 | 2017-07-31 |
| 1700306602 | Jenny Lemus | Behavior Technician | 10200 Nw 25th St Suite 205, Doral, FL 33172 | 2017-06-21 |
| Find all providers in zip 33172 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1982268058 | M.a.t. of The Palm Beaches LLC | Clinic/Center | 321 Northlake Blvd Ste 116, North Palm Beach, FL 33408-5410 | 2019-04-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.