Healthcare Provider Details

I. General information

NPI: 1194038596
Provider Name (Legal Business Name): CARE R US CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4345 SW 72ND AVE G
MIAMI FL
33155-4530
US

IV. Provider business mailing address

4345 SW 72ND AVE G
MIAMI FL
33155-4530
US

V. Phone/Fax

Practice location:
  • Phone: 239-896-7832
  • Fax: 305-675-2668
Mailing address:
  • Phone: 239-896-7832
  • Fax: 305-675-2668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberHCC8369
License Number StateFL

VIII. Authorized Official

Name: FELIX DIAZ
Title or Position: PRESIDENT
Credential:
Phone: 239-896-7832