Healthcare Provider Details

I. General information

NPI: 1033753793
Provider Name (Legal Business Name): OPUSCARE OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9730 E FERN ST
MIAMI FL
33157-5440
US

IV. Provider business mailing address

4960 SW 72ND AVE STE 303
MIAMI FL
33155-5550
US

V. Phone/Fax

Practice location:
  • Phone: 305-591-1606
  • Fax:
Mailing address:
  • Phone: 305-591-1606
  • Fax: 305-591-1618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NICOLAS I ROQUE
Title or Position: ADMINISTRATOR/CCO
Credential:
Phone: 305-591-1606