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General NPI Number Information
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NPI Number | 1417169210
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Entity Type | Organization
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Legal Business Name | INNOVATIVE CARE INC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 12600 PEMBROKE RD SUITE 100
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City | MIRAMAR
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State | FL
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Zip | 33027-2544
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Country | US
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Telephone | 954-432-5400
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Fax | 877-671-4101
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Provider Business Mailing Address
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Address Line | 1 SW 129TH AVE SUITE 109
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1761
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Country | US
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Telephone | 954-450-9595
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Fax | 954-450-9774
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. GOKHAN GUVENLI
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Credential | MD
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Telephone | 954-450-9595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS10374
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME53538
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License Number State | FL
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