Organization
PRIDE CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AIDA CARDENAS (VICE PRESIDENT)
(305) 743-8130
Entity
Organization
Contact information
Practice address
10875 OVERSEAS HWY STE 110, MARATHON, FL 33050-3454
(305) 743-8130
(305) 743-8140
Mailing address
10875 OVERSEAS HWY STE 110, MARATHON, FL 33050-3454
(305) 743-8130
(305) 743-8140
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000412600
—
FL
01
—
0006D
BCBSFL
FL
01
—
8363
HCC LICENSE
FL
Enumeration date
10/17/2008
Last updated
11/10/2009
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