Healthcare Provider Details

I. General information

NPI: 1558270488
Provider Name (Legal Business Name): COMMODORE CARES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9152 ESTATE THOMAS
ST THOMAS VI
00802-2687
US

IV. Provider business mailing address

745 5TH AVE FL 5
NEW YORK NY
10151-0502
US

V. Phone/Fax

Practice location:
  • Phone: 340-203-3535
  • Fax:
Mailing address:
  • Phone: 516-729-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JEANNEMARIE BOZZA
Title or Position: FOUNDER, BOARD PRESIDENT
Credential: RN
Phone: 561-729-5340