MEDICARE: COMMUNITY CARE RESOURCES, LC

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	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1306949128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY CARE RESOURCES, LC

Provider Business Mailing Address
First Line	:	14100 PALMETTO FRONTAGE RD
Second Line	:	STE 100
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1569
Country	:	US
Telephone Number	:	305-231-0404
Fax Number	:	305-231-0402

Provider Business Practice Location Address
First Line	:	14100 PALMETTO FRONTAGE RD
Second Line	:	STE 100
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-1569
Country	:	US
Telephone Number	:	305-231-0404
Fax Number	:	305-231-0402

Authorized Official
Title or Position	:	ADMINISTRATOR/PRESIDENT
Name	:	MR. FRANCISCO VALDES
Credential	:
Telephone Number	:	305-231-0404

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	08/22/2020

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