Healthcare Provider Details

I. General information

NPI: 1295343705
Provider Name (Legal Business Name): CASE MANAGEMENT SERVICES OF SOUTH FLORIDA LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 SUNSET DR STE 103
MIAMI FL
33173-4648
US

IV. Provider business mailing address

9835 SUNSET DR STE 103
MIAMI FL
33173-4648
US

V. Phone/Fax

Practice location:
  • Phone: 305-250-8009
  • Fax:
Mailing address:
  • Phone: 305-250-8009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RAUL VARA
Title or Position: OWNER
Credential:
Phone: 305-250-8009