MEDICARE: BRIDGE OF CARE LLC

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	251B00000X	Case Management Agency	022283100	FL
2	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245752062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGE OF CARE LLC

Provider Business Mailing Address
First Line	:	11401 SW 40TH ST STE 345
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3372
Country	:	US
Telephone Number	:	306-603-7063
Fax Number	:	305-603-8705

Provider Business Practice Location Address
First Line	:	11401 SW 40TH ST STE 345
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3372
Country	:	US
Telephone Number	:	305-603-7063
Fax Number	:	305-603-8705

Authorized Official
Title or Position	:	CEO
Name	:	ALAIN PEREZ HERNANDEZ
Credential	:	CBHCMS
Telephone Number	:	305-603-7063

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	03/04/2026

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Directions to “BRIDGE OF CARE LLC ” Practice Location

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