Healthcare Provider Details

I. General information

NPI: 1265897706
Provider Name (Legal Business Name): ACCOUNTABLE CRITICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 FOREST HILL BLVD
WELLINGTON FL
33414-6103
US

IV. Provider business mailing address

1155 S CONGRESS AVE STE C
PALM SPRINGS FL
33406-5114
US

V. Phone/Fax

Practice location:
  • Phone: 561-766-1300
  • Fax: 561-693-0539
Mailing address:
  • Phone: 561-766-1300
  • Fax: 561-693-0539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTHUR HANSEN
Title or Position: OWNER
Credential: DPM
Phone: 561-766-1300