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General NPI Number Information
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NPI Number | 1407011745
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Entity Type | Organization
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Legal Business Name | INCARE MEDICAL& REHAB CENTER,INC
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 3760 N JOHN YOUNG PKWY STE 103
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City | ORLANDO
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State | FL
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Zip | 32804-3220
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Country | US
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Telephone | 407-914-4452
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Fax |
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Provider Business Mailing Address
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Address Line | 3760 N JOHN YOUNG PKWY STE 103
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City | ORLANDO
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State | FL
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Zip | 32804-3220
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Country | US
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Telephone | 407-914-4452
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Fax |
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Authorized Official
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Title or Position | PRESIDET
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Name | DR. HUMBERTO GUTIERREZ JR.
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Credential | DC
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Telephone | 407-914-4452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 5761
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License Number State | FL
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