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General NPI Number Information
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NPI Number | 1124528161
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Entity Type | Organization
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Legal Business Name | SPEARHEAD HEALTHCARE INC.
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 5812 HOLLYWOOD BLVD
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City | HOLLYWOOD
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State | FL
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Zip | 33021-9998
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Country | US
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Telephone | 954-981-9111
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Fax | 954-967-0250
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Provider Business Mailing Address
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Address Line | 901 BRICKELL KEY BLVD APT 207
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City | MIAMI
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State | FL
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Zip | 33131-3739
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Country | US
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Telephone | 305-582-5370
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. RICARDO A OTAOLA
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Credential |
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Telephone | 305-582-5370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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