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General NPI Number Information
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NPI Number | 1609104439
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Entity Type | Organization
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Legal Business Name | QUALITY CARE PL
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 3800 S OCEAN DR STE G3
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City | HOLLYWOOD
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State | FL
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Zip | 33019-2906
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Country | US
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Telephone | 617-548-7160
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Fax |
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Provider Business Mailing Address
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Address Line | 678 WASHINGTON ST APT.#515
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City | LYNN
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State | MA
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Zip | 01901-1630
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. MICHAIL ORLOV
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Credential | M.D.
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Telephone | 617-548-7160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 94460
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License Number State | FL
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