Healthcare Provider Details

I. General information

NPI: 1922194661
Provider Name (Legal Business Name): PROFESSIONAL CARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 NW 42 AVENUE SUITE 230
MIAMI FL
33126
US

IV. Provider business mailing address

10 NW 42 AVENUE SUITE 230
MIAMI FL
33126
US

V. Phone/Fax

Practice location:
  • Phone: 305-567-9194
  • Fax: 305-567-9914
Mailing address:
  • Phone: 305-567-9194
  • Fax: 305-567-9914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. SIMONA JAMES
Title or Position: PRESIDENT
Credential: PHYSICAL THERAPIST
Phone: 305-567-9194