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General NPI Number Information
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NPI Number | 1124667969
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Entity Type | Organization
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Legal Business Name | ICAREVIP, INC
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Dates
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Enumeration Date | 12/26/2019
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Last Update Date | 12/26/2019
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Provider Practice Location Address
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Address Line | 4800 N. FEDERAL HIGHWAY SUITE 200
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308
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Country | US
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Telephone | 954-771-2111
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Fax | 954-771-7347
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Provider Business Mailing Address
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Address Line | 4800 N. FEDERAL HIGHWAY SUITE 200
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308
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Country | US
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Telephone | 954-771-2111
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Fax | 954-771-7347
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MR. BERNARD GARCIA
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Credential | M.D.
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Telephone | 954-771-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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