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General NPI Number Information
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NPI Number | 1750799888
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Entity Type | Organization
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Legal Business Name | ENCARN MEDICAL SERVICE CENTER INC
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Dates
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Enumeration Date | 08/01/2014
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Last Update Date | 08/02/2014
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Provider Practice Location Address
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Address Line | 2760 PALM AVE STE 102
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City | HIALEAH
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State | FL
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Zip | 33010-1778
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Country | US
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Telephone | 305-219-1620
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Fax |
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Provider Business Mailing Address
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Address Line | 2760 PALM AVE STE 102
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City | HIALEAH
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State | FL
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Zip | 33010-1778
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Country | US
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Telephone | 305-219-1620
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAYDEL ENCARNACION
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Credential |
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Telephone | 305-219-1620
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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 | MA 67026
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License Number State | FL
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