Healthcare Provider Details
I. General information
NPI: 1629896626
Provider Name (Legal Business Name): KARE ONE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1615 S CONGRESS AVE STE 103
DELRAY BEACH FL
33445-6326
US
IV. Provider business mailing address
1615 S CONGRESS AVE STE 103
DELRAY BEACH FL
33445-6326
US
V. Phone/Fax
- Phone: 561-629-7267
- Fax: 561-629-7954
- Phone: 561-629-7267
- Fax: 561-629-7954
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MOISE
WISEMAN
ANGLADE
Title or Position: PRESIDENT
Credential: MD
Phone: 561-629-7267