Healthcare Provider Details

I. General information

NPI: 1285360008
Provider Name (Legal Business Name): TRUCARE NATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 12/09/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 N FEDERAL HWY # 397
LIGHTHOUSE POINT FL
33064-6854
US

IV. Provider business mailing address

2450 N FEDERAL HWY # 397
LIGHTHOUSE POINT FL
33064-6854
US

V. Phone/Fax

Practice location:
  • Phone: 954-654-2549
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RONNIE BERRY
Title or Position: MGR
Credential:
Phone: 954-654-2549