Healthcare Provider Details

I. General information

NPI: 1083174585
Provider Name (Legal Business Name): JC THERAPY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7225 NW 25TH ST STE 214
MIAMI FL
33122-1709
US

IV. Provider business mailing address

7225 NW 25TH ST STE 214
MIAMI FL
33122-1709
US

V. Phone/Fax

Practice location:
  • Phone: 305-406-0488
  • Fax: 305-406-9025
Mailing address:
  • Phone: 305-406-0488
  • Fax: 305-406-9025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIO CESAR DOGER
Title or Position: OWNER
Credential:
Phone: 305-613-7050