MEDICARE: 1ST CARE CASE MANAGEMENT SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	103K00000X	Behavior Analyst
3	251S00000X	Community/Behavioral Health Agency
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

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	:	1518472414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1ST CARE CASE MANAGEMENT SERVICES LLC

Provider Business Mailing Address
First Line	:	1150 NW 72ND AVE PH 2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-1920
Country	:	US
Telephone Number	:	786-542-5043
Fax Number	:	786-542-5049

Provider Business Practice Location Address
First Line	:	1150 NW 72ND AVE PH 2
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-1920
Country	:	US
Telephone Number	:	786-542-5043
Fax Number	:	786-542-5049

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDERSON CHAVEZ
Credential	:
Telephone Number	:	786-542-5043

Provider Enumeration Date	:	12/13/2017
Last Update Date	:	02/17/2026

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