MEDICARE: CONTINUCARE MEDICAL MANAGEMENT INC

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	332900000X	Non-Pharmacy Dispensing Site		FL
2	261QM1300X	Multi-Specialty Clinic/Center	HCC 9209	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053695163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONTINUCARE MEDICAL MANAGEMENT INC

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR
Second Line	:	SUITE 400
City	:	MIAMI
State	:	FL
Zip	:	33126-2055
Country	:	US
Telephone Number	:	305-500-2114
Fax Number	:	305-370-6024

Provider Business Practice Location Address
First Line	:	3100 STIRLING RD
Second Line	:	SUITE A
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2040
Country	:	US
Telephone Number	:	954-962-9811
Fax Number	:	954-963-6317

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	GEMMA GEMMA
Credential	:
Telephone Number	:	305-500-2000

Provider Enumeration Date	:	10/07/2011
Last Update Date	:	06/10/2016

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