MEDICARE: CARE NETWORK GROUP 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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1821611211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE NETWORK GROUP LLC

Provider Business Mailing Address
First Line	:	13270 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1178
Country	:	US
Telephone Number	:	786-399-3933
Fax Number	:

Provider Business Practice Location Address
First Line	:	13270 SW 8TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-1178
Country	:	US
Telephone Number	:	786-399-3933
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JORGE JAEN
Credential	:
Telephone Number	:	786-399-3933

Provider Enumeration Date	:	05/20/2020
Last Update Date	:	05/20/2020

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