MEDICARE: FLORIDA CARE HEALTH CENTER CORP

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	261QM1300X	Multi-Specialty Clinic/Center	HCC7153	FL

General Provider Information

NPI Number	:	1275544124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA CARE HEALTH CENTER CORP

Provider Business Mailing Address
First Line	:	11300 NW 87TH CT
Second Line	:	SUITE 141
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4586
Country	:	US
Telephone Number	:	305-364-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	11300 NW 87TH CT
Second Line	:	SUITE 141
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4586
Country	:	US
Telephone Number	:	305-364-8600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT / OWNER
Name	:	OLINDA BAUZA
Credential	:
Telephone Number	:	305-364-8600

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	08/08/2007

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