Healthcare Provider Details

I. General information

NPI: 1821406828
Provider Name (Legal Business Name): SUPPORTIVE HEALTH SYSTEMS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 BRICKELL AVE UNIT C401
MIAMI FL
33129-1736
US

IV. Provider business mailing address

1915 BRICKELL AVE UNIT C401
MIAMI FL
33129-1736
US

V. Phone/Fax

Practice location:
  • Phone: 305-773-6049
  • Fax: 305-858-7266
Mailing address:
  • Phone: 305-773-6049
  • Fax: 305-858-7266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1744R1103X
TaxonomyResearch Study Abstracter/Coder
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KARLA M ARRECHEA
Title or Position: PRESIDENT
Credential:
Phone: 305-773-6049