Healthcare Provider Details

I. General information

NPI: 1467702092
Provider Name (Legal Business Name): FLORIDA SENIOR CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 N UNIVERSITY DR
SUNRISE FL
33322-3936
US

IV. Provider business mailing address

2039 N UNIVERSITY DR
SUNRISE FL
33322-3936
US

V. Phone/Fax

Practice location:
  • Phone: 954-530-9065
  • Fax: 954-530-9548
Mailing address:
  • Phone: 954-530-9065
  • Fax: 954-530-9548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK ANTHONY ALIE
Title or Position: DIRECTOR
Credential:
Phone: 954-709-4932