MEDICARE: ROUND CARE, 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	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	ME47100	FL
2	363LF0000X	Family Nurse Practitioner	ARNP9299227	FL
3	207Q00000X	Family Medicine Physician	OS5102	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OS512	OTHER	FL	FAMILY MEDICINE
2	ARNP9299227	OTHER	FL	NURSE PRACTITIONER

General Provider Information

NPI Number	:	1255879060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROUND CARE, INC

Provider Business Mailing Address
First Line	:	300 W SUNRISE BLVD STE 3
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-6200
Country	:	US
Telephone Number	:	754-234-0155
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 W SUNRISE BLVD STE 3
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33311-6200
Country	:	US
Telephone Number	:	754-234-0155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RICHARD STERNE
Credential	:	MSN, ARNP, FNP-BC
Telephone Number	:	754-234-0155

Provider Enumeration Date	:	02/01/2017
Last Update Date	:	09/19/2017

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Directions to “ROUND CARE, INC ” Practice Location

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