MEDICARE: HIGI CARE NETWORK (DE), P.A.

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1063001238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGI CARE NETWORK (DE), P.A.

Provider Business Mailing Address
First Line	:	382 NE 191ST ST STE 50294
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-3899
Country	:	US
Telephone Number	:	303-898-6737
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 N STATE ROAD 7 STE 102
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5868
Country	:	US
Telephone Number	:	561-381-9258
Fax Number	:

Authorized Official
Title or Position	:	VP, CLINICAL OPERATIONS & STRATEGY
Name	:	ERIC JAMES CHIYEMBEKEZA
Credential	:
Telephone Number	:	561-568-5440

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	12/21/2021

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