Healthcare Provider Details

I. General information

NPI: 1912194911
Provider Name (Legal Business Name): CONTINUCARE CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 CORPORATE CENTER DR #600
MIAMI FL
33126-1200
US

IV. Provider business mailing address

7200 CORPORATE CENTER DR #600
MIAMI FL
33126-1200
US

V. Phone/Fax

Practice location:
  • Phone: 305-500-2000
  • Fax: 305-500-2080
Mailing address:
  • Phone: 305-500-2000
  • Fax: 305-500-2080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD CHARLES PFENNIGER JR.
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 305-500-2100