Healthcare Provider Details

I. General information

NPI: 1609794064
Provider Name (Legal Business Name): SOUTH CORE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1495 NE 179TH ST
NORTH MIAMI BEACH FL
33162-1340
US

IV. Provider business mailing address

550 NE 175TH TER
NORTH MIAMI BEACH FL
33162-1948
US

V. Phone/Fax

Practice location:
  • Phone: 646-813-7502
  • Fax:
Mailing address:
  • Phone: 646-813-7502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MARSHALL IAN COTARELO
Title or Position: OWNER
Credential:
Phone: 646-813-7502