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General NPI Number Information
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NPI Number | 1487447488
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Entity Type | Organization
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Legal Business Name | LOVING CARE MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 5084 NW 74TH AVE
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City | MIAMI
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State | FL
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Zip | 33166-5554
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Country | US
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Telephone | 786-907-4942
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Fax | 305-530-8537
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Provider Business Mailing Address
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Address Line | 5084 NW 74TH AVE
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City | MIAMI
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State | FL
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Zip | 33166-5554
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Country | US
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Telephone | 786-907-4942
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Fax | 305-530-8537
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Authorized Official
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Title or Position | OWNER/FINANCIAL ADMINISTRATOR
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Name | TIFFANY COELLO
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Credential |
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Telephone | 786-229-6872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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