Healthcare Provider Details

I. General information

NPI: 1467108142
Provider Name (Legal Business Name): TRUCARE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW 82ND AVE STE 305
PLANTATION FL
33324-1855
US

IV. Provider business mailing address

201 NW 82ND AVE STE 305
PLANTATION FL
33324-1855
US

V. Phone/Fax

Practice location:
  • Phone: 954-533-8353
  • Fax: 954-533-8230
Mailing address:
  • Phone: 954-533-8353
  • Fax: 954-533-8230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: GIEZY SARDINAS
Title or Position: OWNER
Credential: MD
Phone: 954-533-8353