Healthcare Provider Details

I. General information

NPI: 1174540017
Provider Name (Legal Business Name): CARICARE FAMILY HEALTH SERVICES, L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS PARAGON MEDICAL BUILDING, SUITE 301
ST THOMAS VI
00802-2687
US

IV. Provider business mailing address

PO BOX 307266
ST THOMAS VI
00803-7266
US

V. Phone/Fax

Practice location:
  • Phone: 340-776-8112
  • Fax: 340-776-8113
Mailing address:
  • Phone: 340-776-8112
  • Fax: 340-776-8113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: REVA A RICHARDSON
Title or Position: MANAGER
Credential: MD
Phone: 340-776-8112