Healthcare Provider Details

I. General information

NPI: 1568775435
Provider Name (Legal Business Name): GTC HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2010
Last Update Date: 11/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 N. 46TH AVE.
HOLLYWOOD FL
33021
US

IV. Provider business mailing address

2006 N. 46TH AVE.
HOLLYWOOD FL
33021
US

V. Phone/Fax

Practice location:
  • Phone: 954-534-5773
  • Fax:
Mailing address:
  • Phone: 954-534-5773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN9212291
License Number StateFL

VIII. Authorized Official

Name: BARBARA IRIZARRY-LUKE
Title or Position: PRESIDENT
Credential: RN
Phone: 954-534-5773