MEDICARE: APPLIED SOLUTIONS CARE 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	261QD1600X	Developmental Disabilities Clinic/Center

General Provider Information

NPI Number	:	1174224687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLIED SOLUTIONS CARE LLC

Provider Business Mailing Address
First Line	:	644 SE PARK DR APT B
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5652
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	644 SE PARK DR APT B
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5652
Country	:	US
Telephone Number	:	305-833-8488
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARIA MEDINA
Credential	:
Telephone Number	:	305-833-8488

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	03/13/2023

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Directions to “APPLIED SOLUTIONS CARE LLC ” Practice Location

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