Healthcare Provider Details

I. General information

NPI: 1013501113
Provider Name (Legal Business Name): ALL INCLUSIVE PREVENTIVE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 10/05/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 NW 151ST ST STE 203
MIAMI LAKES FL
33014-2442
US

IV. Provider business mailing address

5881 NW 151ST ST STE 203
MIAMI LAKES FL
33014-2442
US

V. Phone/Fax

Practice location:
  • Phone: 305-200-3141
  • Fax: 786-332-3854
Mailing address:
  • Phone: 305-200-3141
  • Fax: 786-332-3854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. EVELYN RODRIGUEZ
Title or Position: MANAGING MEMBER
Credential: APRN
Phone: 786-897-8975