Healthcare Provider Details

I. General information

NPI: 1629362751
Provider Name (Legal Business Name): OUTSOURCE HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 10/20/2024
Certification Date: 10/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NE 125TH ST
NORTH MIAMI FL
33161-6034
US

IV. Provider business mailing address

1400 NE 125TH ST
NORTH MIAMI FL
33161-6034
US

V. Phone/Fax

Practice location:
  • Phone: 305-915-8900
  • Fax: 305-762-5882
Mailing address:
  • Phone: 305-915-8900
  • Fax: 305-892-2554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN2989182
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAROL JOY BIGGS-OWENS
Title or Position: CEO
Credential: REGISTERED NURSE
Phone: 305-915-8900