Healthcare Provider Details

I. General information

NPI: 1174491401
Provider Name (Legal Business Name): BASICARE FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6705 SW 57TH AVE STE 318
SOUTH MIAMI FL
33143-3638
US

IV. Provider business mailing address

6705 SW 57TH AVE STE 318
SOUTH MIAMI FL
33143-3638
US

V. Phone/Fax

Practice location:
  • Phone: 786-800-9998
  • Fax:
Mailing address:
  • Phone: 786-800-9998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YONG LUO
Title or Position: MD/PRESIDENT
Credential: MD
Phone: 718-886-2828