MEDICARE: DREAM TEAM CONSULTING GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1033428669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREAM TEAM CONSULTING GROUP

Provider Business Mailing Address
First Line	:	1864 CALLE SAN ALVARO
Second Line	:	URB. SAN JUAN GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5320
Country	:	US
Telephone Number	:	787-281-6116
Fax Number	:	787-281-6116

Provider Business Practice Location Address
First Line	:	1864 SAN ALVARO
Second Line	:	URB. SAN JUAN GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5320
Country	:	US
Telephone Number	:	787-281-6116
Fax Number	:	787-281-6116

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDGAR JERRY RENTAS
Credential	:	ED.D., MBA
Telephone Number	:	787-403-6832

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	09/30/2010

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