# CAREVANTAGE MEDICAL CENTERS OF MIAMI AT CIVIC CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114294097
- **Authorized official:** ROBERT THORNE (OWNER)
- **Authorized official phone:** (305) 324-7900

## Contact information

- **Practice address:** 1433 NW 13TH TER, MIAMI, FL 33125-2607
- **Practice address phone:** (305) 324-7900
- **Mailing address:** 1433 NW 13TH TER, MIAMI, FL 33125-2607
- **Mailing address phone:** (305) 324-7900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2011
- **Last updated:** 11/21/2011