Healthcare Provider Details

I. General information

NPI: 1184596637
Provider Name (Legal Business Name): INTENSIVE CARE EXPERTS HEALTH NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3051 BUFFALO RD
LAWRENCEBURG TN
38464-6189
US

IV. Provider business mailing address

701 N FEDERAL HWY
HALLANDALE BEACH FL
33009-2449
US

V. Phone/Fax

Practice location:
  • Phone: 931-762-7518
  • Fax:
Mailing address:
  • Phone: 954-482-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GUSTAVO FERRER
Title or Position: CEO
Credential: MD
Phone: 954-482-4747