Healthcare Provider Details

I. General information

NPI: 1336872720
Provider Name (Legal Business Name): 4POINT HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12011 SW 129TH CT UNIT 6
MIAMI FL
33186-6933
US

IV. Provider business mailing address

12011 SW 129TH CT UNIT 6
MIAMI FL
33186-6933
US

V. Phone/Fax

Practice location:
  • Phone: 786-624-7723
  • Fax:
Mailing address:
  • Phone: 786-624-7723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. GABRIEL DIAZ
Title or Position: PRES
Credential:
Phone: 786-624-7723