Healthcare Provider Details

I. General information

NPI: 1588375901
Provider Name (Legal Business Name): IMMACULATE CAREERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20801 BISCAYNE BLVD
AVENTURA FL
33180-1430
US

IV. Provider business mailing address

PO BOX 641005
NORTH MIAMI BEACH FL
33164-1005
US

V. Phone/Fax

Practice location:
  • Phone: 954-326-2786
  • Fax:
Mailing address:
  • Phone: 954-326-2786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. MANOUSHKA REMOGENE
Title or Position: DIRECTOR
Credential:
Phone: 305-308-0039