Healthcare Provider Details

I. General information

NPI: 1003400243
Provider Name (Legal Business Name): PROBITYCARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 NE 4TH AVE APT 404
MIAMI FL
33137-4915
US

IV. Provider business mailing address

2200 NE 4TH AVE APT 404
MIAMI FL
33137-4915
US

V. Phone/Fax

Practice location:
  • Phone: 781-654-5718
  • Fax:
Mailing address:
  • Phone: 781-654-5718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL JEAN
Title or Position: COO
Credential:
Phone: 781-654-5718