MEDICARE: SUPREME PATIENT CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194997056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPREME PATIENT CARE INC

Provider Business Mailing Address
First Line	:	2880 W OAKLAND PARK BLVD
Second Line	:	SUITE 125 C
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1354
Country	:	US
Telephone Number	:	267-716-3333
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 W OAKLAND PARK BLVD
Second Line	:	SUITE 125 C
City	:	OAKLAND PARK
State	:	FL
Zip	:	33311-1354
Country	:	US
Telephone Number	:	267-716-3333
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VLADIMIR DUBROVIN
Credential	:
Telephone Number	:	267-716-3333

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	03/31/2008

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Directions to “SUPREME PATIENT CARE INC ” Practice Location

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