MEDICARE: INTENSIVE CARE EXPERTS HEALTH NETWORK LLC

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
2	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1164824397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTENSIVE CARE EXPERTS HEALTH NETWORK LLC

Provider Business Mailing Address
First Line	:	701 N FEDERAL HWY # 601
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2449
Country	:	US
Telephone Number	:	954-482-4747
Fax Number	:	954-301-5939

Provider Business Practice Location Address
First Line	:	701 N FEDERAL HWY # 601
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2449
Country	:	US
Telephone Number	:	954-482-4747
Fax Number	:	954-301-5939

Authorized Official
Title or Position	:	FINANCIAL CONTROLLER
Name	:	ERIC JARQUIN
Credential	:
Telephone Number	:	954-651-8332

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	05/29/2026

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