=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891264800
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INPATIENT CARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/19/2018
-----------------------------------------------------
Last Update Date | 11/19/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5190 SW 8TH ST
-----------------------------------------------------
City | CORAL GABLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33134-2476
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-661-9404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8600 SW 92ND ST STE 204A
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33156-7377
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-436-9933
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD
-----------------------------------------------------
Name | JAVIER PEREZ-FERNANDEZ
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 305-661-9404
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------