Healthcare Provider Details

I. General information

NPI: 1740114719
Provider Name (Legal Business Name): SUMMIT CARE ACO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 SW 148TH AVE STE 202
MIRAMAR FL
33027-3239
US

IV. Provider business mailing address

3350 SW 148TH AVE STE 202
MIRAMAR FL
33027-3239
US

V. Phone/Fax

Practice location:
  • Phone: 866-825-8380
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL ROBERTS
Title or Position: CEO
Credential:
Phone: 727-739-6361