Healthcare Provider Details

I. General information

NPI: 1750288023
Provider Name (Legal Business Name): CARESPACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2026
Last Update Date: 10/21/2026
Certification Date: 10/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9325 GLADES RD STE 105
BOCA RATON FL
33434-3988
US

IV. Provider business mailing address

971 US HIGHWAY 202 N # 7902
BRANCHBURG NJ
08876-3757
US

V. Phone/Fax

Practice location:
  • Phone: 870-846-0378
  • Fax: 870-846-0378
Mailing address:
  • Phone: 870-846-0378
  • Fax: 870-846-0378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DOMINIK CHRZAN
Title or Position: MGR
Credential:
Phone: 870-846-0378