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General NPI Number Information
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NPI Number | 1437802279
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Entity Type | Organization
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Legal Business Name | FALOCARE NETWORK
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1552 NE 4TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304
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Country | US
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Telephone | 954-467-8855
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Fax |
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Provider Business Mailing Address
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Address Line | 6142 MIRAMAR PARKWAY, SUITE D
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City | MIRAMAR
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State | FL
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Zip | 33023
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Country | US
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Telephone | 954-591-6130
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MR. CHARLES HARRY RICHARD
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Credential | DO
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Telephone | 754-368-0475
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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 |
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License Number State |
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