MEDICARE: VALUECARE FAMILY CLINIC 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	261Q00000X	Clinic/Center	ARNP9267853	FL

General Provider Information

NPI Number	:	1215359286
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALUECARE FAMILY CLINIC INC

Provider Business Mailing Address
First Line	:	7001 ENVIRON BLVD APT 507
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-4272
Country	:	US
Telephone Number	:	954-918-1529
Fax Number	:

Provider Business Practice Location Address
First Line	:	3898 W COMMERCIAL BLVD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33309-3326
Country	:	US
Telephone Number	:	954-918-1529
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RITA GERMAIN
Credential	:	ARNP
Telephone Number	:	954-918-1529

Provider Enumeration Date	:	01/10/2014
Last Update Date	:	02/27/2014

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